超纯透析对维持性血液透析患者微炎症状态及血管通路使用寿命的影响  

Effect of ultrapure dialysis on the micro-inflammatory state and vascular access lifespan in maintenance hemodialysis patients

作　　者：曾庆义[1] 曾琪[2] 罗素珊 陈琼娣[3] 李翠谊 ZENG Qingyi;ZENG Qi;LUO Sushan;CHEN Qiongdi;LI Cuiyi(Department of Nephrology,Huizhou Third People's Hospital,Guangdong Province,Huizhou516002,China;Department of Emergency,Huizhou Third People's Hospital,Guangdong Province,Huizhou516002,China;Department of Laboratory,Huizhou Third People's Hospital,Guangdong Province,Huizhou516002,China)

机构地区：[1]广东省惠州市第三人民医院肾内科,广东惠州516002 [2]广东省惠州市第三人民医院急诊科,广东惠州516002 [3]广东省惠州市第三人民医院检验科,广东惠州516002

出　　处：《中国当代医药》2025年第10期79-83,共5页China Modern Medicine

基　　金：广东省惠州市医疗卫生领域科技计划项目(2023 CZ010169)。

摘　　要：目的探讨超纯透析对维持性血液透析患者微炎症状态及血管通路使用寿命的影响。方法回顾性分析2022年1月至12月惠州市第三人民医院收治的150例接受维持性血液透析患者的临床资料,按照透析方法将其分为常规组(75例)与超纯组(75例),常规组患者采用常规透析方法,超纯组患者采用超纯透析方法。比较两组患者血清炎症因子、透析充分性、营养状态、钙磷代谢、全段甲状旁腺激素(iPTH)的变化。结果透析后,超纯组的血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、尿素氮(BUN)、血肌酐(SCr)、β_(2)-微球蛋白(β_(2)-MG)、磷(P)、iPTH水平均低于常规组,血清白蛋白(ALB)、血红蛋白(Hb)、尿素氮下降率(URR)水平均高于常规组,差异有统计学意义(P<0.05)。结论超纯透析可减轻维持性血液透析患者微炎症状态,降低血管通路不良事件发生风险,更好地维持患者钙磷代谢、血脂代谢水平,改善患者透析充分性、营养状态,有利于降低肾性贫血的发生风险。Objective To explore the effect of ultrapure dialysis on the micro-inflammatory state and vascular access lifespan in maintenance hemodialysis patients.Methods The clinical data of 150 patients who received maintenance hemodialysis in Huizhou Third People's Hospital from January to December 2022 were retrospectively analyzed.According to the dialysis method,the patients were divided into conventional group(75 cases)and ultrapure group(75 cases).Patients in the conventional group were treated with conventional dialysis,and patients in the ultrapure group were treated with ultrapure dialysis.The changes of serum inflammatory factors,dialysis adequacy,nutritional status,calcium and phosphorus metabolism and intact parathyroid hormone(iPTH)were compared between the two groups.Results After dialysis,the levels of serum C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),blood urea nitrogen(BUN),serum creatinine(SCr),β_(2)-microglobulin(β_(2)-MG),phosphorus(P)and iPTH in ultrapure group were lower than those in conventional group,and the levels of serum albumin(ALB),hemoglobin(Hb)and urea nitrogen reduction rate(URR)in the ultrapure group were higher than those in the conventional group,and the differences were statistically significant(P<0.05).Conclusion Ultrapure dialysis can reduce the microinflammatory state of maintenance hemodialysis patients,reduce the risk of vascular access adverse events,better maintain the level of calcium and phosphorus metabolism and lipid metabolism of patients,improve the dialysis adequacy and nutritional status of patients,and help to reduce the risk of renal anemia.

关 键 词：维持性血液透析 超纯透析 血管通路寿命 微炎症状态 

分 类 号：R459.5[医药卫生—治疗学]