不同透析方式对维持性血液透析患者的影响

Effects of different dialysis methods for patients with maintenance hemodialysis

  • 摘要: 目的 分析不同透析方式对维持性血液透析(MHD)患者尿毒症毒素、炎症因子水平的影响。 方法 采用随机数字表法将130例MHD患者分为对照组和观察组,每组65例。对照组采用高通量血液透析治疗,观察组采用高通量血液透析联合血液透析滤过(HDF)治疗,观察2组的治疗效果和不良反应,并比较2组治疗前后尿毒症毒素[血磷、β2-微球蛋白(β2-MG)、同型半胱氨酸(Hcy)]、炎症因子[白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子(TNF-α)]水平。 结果 观察组的总有效率高于对照组,差异有统计学意义(P<0.05); 治疗后,观察组血磷、β2-MG、Hcy水平和IL-6、IL-8、TNF-α水平均低于对照组,差异有统计学意义(P<0.05); 2组低血压、肌肉痉挛、出血/渗血和心血管不良事件发生率比较,差异无统计学意义(P>0.05)。 结论 高通量血液透析联合HDF治疗对MHD患者尿毒症毒素、炎症因子的清除效果优于单纯高通量血液透析治疗,且不会增加不良反应。

     

    Abstract: Objective To analyze the effects of different dialysis methods on uremic toxin, inflammatory factors in patients with maintenance hemodialysis(MHD). Methods A total of 130 patients with MHD were selected and divided into control group and observation group according to the random number table method, with 65 cases in each group. The control group was given high-flux hemodialysis, and the observation group was given high-flux hemodialysis combined with hemodiafiltration(HDF). The curative effects and adverse reactions were observed, and levels of uremic toxins [blood phosphorus, β2-microglobulin(β2-MG), homocysteine(Hcy)] and inflammatory factors [interleukin-6(IL-6), interleukin-8(IL-8), tumor necrosis factor(TNF-ɑ)] before and after treatment between the two groups were compared. Results The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05). The levels of blood phosphorus, β2-MG, Hcy, and the levels of IL-6, IL-8 and TNF-ɑ in the observation group were significantly lower than those in control group(P<0.05). There were no significant differences in the incidence rates of hypotension, muscle spasm, bleeding, errhysis and cardiovascular adverse events in two groups(P>0.05). Conclusion High-flux hemodialysis combined with HDF has better effects on clearance of uremic toxin and inflammatory factors than hemodialysis alone in patients with MHD, and does not increase adverse reactions.

     

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