高原地区高通量透析对维持性血液透析患者肾性贫血影响的研究  

Study on the effect of high-flux dialysis on renal anemia in patients on maintenance hemodialysis at high altitudes

作　　者：李国梁[1] 李磊[2] Li Guoliang;Li Lei(Department of Nephrology,People's Hospital of Xizang Autonomous Region,Lhasa 850000,China;Department of Laboratory,Fukang Hospital Affiliated to Xizang University,Lhasa 850000,China)

机构地区：[1]西藏自治区人民医院肾内科,拉萨850000 [2]西藏大学附属阜康医院实验室,拉萨850000

出　　处：《西藏科技》2024年第12期54-59,共6页Xizang Science And Technology

基　　金：西藏自治区人民医院院内科研项目(XZQYY2020008)。

摘　　要：目的探究高原地区高通量透析对于维持性血液透析患者肾性贫血的影响情况。方法选取2021年1月至2022年2月在西藏自治区人民医院血液净化中心进行维持性血液透析临床治疗的100例患者。随机将患者分为观察组(50例)及对照组(50例),观察组予以高通量血液透析,对照组予以低通量血液透析,规律透析并随访12个月。比较两组治疗前后血红蛋白、血清肌酐、尿素氮及C反应蛋白水平变化,应用促红细胞生成素剂量变化及SF-36量表评分变化,并比较两组尿素清除指数Kt/V及不良反应发生率。结果最终有91例顺利随访,透析治疗12个月后,观察组患者血红蛋白水平及Kt/V高于对照组,促红细胞生成素每周应用剂量低于对照组,差异均有统计学意义(P<0.05)。治疗后观察组SF-36量表平均分值(61.72±8.07)高于对照组(49.98±7.85)(P<0.05),观察组生存质量高于对照组。与此同时,两组患者应用不同通量透析器的不良反应总发生率差异无统计学意义(P>0.05)。结论采用高通量透析能够改善维持性血液透析患者肾性贫血和生存质量,而且高通量透析不良反应少、安全性高。Objective To explore the effect of high-flux dialysis on renal anemia in patients with maintenance hemodialysis at high altitudes.Methods A total of 100 patients who underwent clinical treatment for maintenance hemodialysis at the Blood Purification Center of the People's Hospital of the Tibet Autonomous Region from January 2021 to February 2022 were selected.The patients were randomly divided into observation group(50 cases)and control group(50 cases).The observation group was given high-flux hemodialysis,and the control group was given low-flux hemodialysis,and the regular dialysis was followed up 12 months.Changes of hemoglobin,serum creatinine,urea nitrogen and C-reactive protein levels before and after treatment were compared between the two groups;the changes in erythropoietin dose and SF-36 scale score were compared between the two groups;and the urea clearance index Kt/V and the incidence of adverse reactions were compared between the two groups.Results A total of 91 cases were successfully followed up.After 12 months of dialysis treatment,the hemoglobin level and Kt/V of the observation group were higher than those of the control group,and the weekly dose of erythropoietin was lower than that of the control group.The differences were statistically significant(P<0.05 for both).After treatment,the average score of SF-36 scale in the observation group(61.72±8.07)was higher than that in the control group(49.98±7.85)(P<0.05),and the quality of life in the observation group was higher than that in the control group.At the same time,there was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion High-flux dialysis can improve renal anemia and quality of life in maintenance hemodialysis patients,and has fewer adverse reactions and high safety.

关 键 词：高原 维持性血液透析 贫血 高通量透析 

分 类 号：R47[医药卫生—护理学]