摘要
目的:比较腹膜透析和血液透析对慢性肾衰竭患者微炎症状态和生活质量的影响。方法:选取我院2014年11月~2016年9月因慢性肾衰竭需住院治疗患者96例,按入院先后顺序分为观察组和对照组,每组48例。观察组予以腹膜透析,对照组予以血液透析,比较两组治疗前后血清超敏C反应蛋白(hc-C-reactive protein,hs-CRP)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、血尿素氮(blood urea nitrogen,BUN)、血肌酐(Serum creatinine,Scr)和白蛋白(albumin,ALB)水平、血红蛋白(hemoglobin,HB)和红细胞(red blood cell,RBC)值、SF-36量表生活质量评分(the MOS item short from health survey)的变化及并发症的发生情况。结果:治疗后,观察组血清hs-CRP、IL-6、TNF-α、BUN、Scr和ALB水平均显著低于对照组,HB和RBC值明显高于对照组,差异均具有统计学意义(P<0.05)。观察组治疗后并发心脑血管疾病的发生率显著低于对照组,并发低蛋白血症率和感染得发生率显著高于对照组,差异具有统计学意义(P<0.05),但两组总并发症发生率比较差异无统计学意义(P>0.05)。观察组治疗6个月后体力功能、总体健康、心理健康评分与对照组比较差异无统计学意义(P>0.05),躯体疼痛、生命活力、社会职能、生理职能和情感职能评分均显著高于对照组,差异具有统计学意义(P<0.05)。结论:腹膜透析对慢性肾衰竭患者的临床效果较好,较血液透析可更有效抑制患者的微炎症状态,提高小分子物质清除率,改善生活质量,降低心脑血管疾病发生率,但治疗中易发生低蛋白血症和感染等并发症,需及时补充白蛋白和加强预防感染措施等对症处理。
Objective： To compare the effects of peritoneal dialysis and hemodialysis on the microinflammatory state and quality of life of patients with chronic renal failure. Methods： From November 2014 to September 2016, 96 cases of patients with chronic renal failure were selected and divided into the observation group and the control group according to the order of admission, with 48 cases in each group, the observation group was treated with peritoneal dialysis, the control group was treated with hemodialysis, the levels of serum hs-CRP（hs-C-reactive protein）, interleukin-6（IL-6） and Tumor necrosis factor-α（TNF-α）, blood urea nitrogen（BUN）, serum creatinine（Scr） and albumin albumin（ALB） levels, hemoglobin（HB） and red blood cell（RBC）, SF-36 scale and the incidence of complications were compared between two groups before and after treatment. Results： After treatment, the levels of serum hs-CRP, IL-6,TNF-α, BUN, Scr and ALB were significantly lower in the observation group than those in the control group, the HB and RBC levels were significantly higher than those in the control group（P〈0.05）. The incidence of cardiovascular and cerebrovascular disease in the observation group was significantly lower than that in the control group, and the incidence of hypoalbuminemia and infection was significantly higher than that of the control group（P〈0.05）; but there was no significant difference in the incidence of total complications between the two groups（P〉0.05）. there was no significant difference in the physical function, overall health and mental health score between two groups（P〈0.05）, the body pain, vitality, social function, physiological function and emotional function score were significantly higher than those of the control group（P〈0.05）. Conclusion： Peritoneal dialysis was more effective in the treatment of patients with chronic renal failure than hemodialysis, which couldeffectively inhibit the microinflammatory state of patients, improve the clearance rate of small molecules, quality of life and reduce the incidence of cardiovascular and cerebrovascular diseases, but the treatment is easy to induce hypoproteinemia and infection and other complications, prompt addition of albumin and prevention of infection and other symptomatic treatment were needed during the treatment.
作者
邵秋媛
张苗
张庆燕
赵敏
万骋
孙琤
王恒进
SHAO Qiu-yuan;ZHANG Miao;ZHANG Qing-yan;ZHAO Min;WAN Cheng;SUN Zheng;WANG Heng-jin(Department of Nephrology,Drum Tower Hospital,Medical College of Nanjing University,Nanjing,Jiangsu,210008,China)
出处
《现代生物医学进展》
CAS
2018年第13期2478-2482,共5页
Progress in Modern Biomedicine
关键词
腹膜透析
血液透析
慢性肾衰竭
炎性因子
生活质量
Peritoneal dialysis
Hemodialysis
Chronic renal failure
Inflammatory factors
Quality of life
