摘要
目的研究高通量血液透析和血液透析滤过对慢性肾功能衰竭(CRF)患者临床疗效、肾功能及毒素清除率的影响。方法选取2017年4月—2018年5月我院收治疗的慢性肾功能衰竭患者96例,根据不同的治疗方式分为对照组与观察组,每组48例。对照组给予常规血液透析,观察组给予高通量血液透析。观察并记录2组治疗前后肾功能指标情况、毒素清除率、临床疗效和不良反应发生情况。结果观察组临床总有效率显著高于对照组(P<0.05)。2组治疗后胱抑素C、血尿素氮、血肌苷水平均较治疗前降低,且观察组明显低于对照组(P<0.05)。2组治疗后血钾、血磷、甲状腺激素(PTH)水平均低于治疗前,且观察组低于对照组;血钾、血磷、PTH清除率高于治疗前,且观察组高于对照组(P<0.05)。2组治疗后血β2微球蛋白(β2-MG)水平低于治疗前,且观察组高于对照组,观察组β2-MG清除率低于对照组(P<0.05)。观察组不良反应总发生率显著低于对照组(P<0.05)。结论HFDF对大部分有毒物质的清除率显著高于HDF,通过降低血液中有毒物质的积累,以此改善患者各临床症状,提高其肾功能水平,且具有更高安全性。
Objective To study effects of high-flux hemodialysis and hemodiafiltration on clinical efficacy,renal function and toxin clearance in patients with chronic renal failure(CRF).Methods A total of 96 CRF patients admitted during April 2017 and May 2018 were divided into control group and observation group(n=48 in each group)according to different therapeutic Methods.Control group was treated with routine hemodiafiltration,while observation group was treated with high-flux hemodialysis.Renal function indexes,toxin clearance rate,clinical efficacy and incidence rate of adverse reactions before and after treatment were observed and recorded.Results The total effective rate in observation group was significantly higher than that in control group(P<0.05).After treatment,levels of cystatin C(CysC),blood urea nitrogen(BUN)and serum creatinine(SCr)were significantly lower than those before treatment in two groups,and the levels in observation group were significantly lower than those in control group(P<0.05);levels of serum potassium,serum phosphate and parathyroid hormone(PTH)were significantly lower than those before treatment in two groups,and the levels in observation group were significantly lower than those in control group;clearance rates of serum potassium,serum phosphate and PTH were significantly higher than those before treatment in two groups,and the rates in observation group were significantly higher than those in control group(P<0.05).After treatment,β2-microglobulin(β2-MG)levels were significantly lower than those before treatment in two groups,and the level in observation group was significantly higher than that in control group,while clearance rate ofβ2-MG in observation group was significantly lower than that in control group(P<0.05).The total incidence rate of adverse reactions in observation group was significantly lower than that in control group(P<0.05).Conclusion Clearance rates of most toxic substances by high-flux hemodialysis are significantly higher than those of hemodiafiltration.By reducing accumulation of toxic substances in blood,clinical symptoms and renal functions of patients may be improved with good safety.
作者
龚豪
黄丽
张庆红
李涛
史秀岩
GONG Hao;HUANG Li;ZHANG Qing-hong;LI Tao;SHI Xiu-yan(Department of Nephrology,Taihe Hospital of Shiyan City Affiliated to Hubei Medical College,Shiyan,Hubei 442000,China;Department of Gynecology,Taihe Hospital of Shiyan City Affiliated to Hubei Medical College,Shiyan,Hubei 442000,China)
出处
《解放军医药杂志》
CAS
2019年第8期62-65,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
湖北省自然科学基金资助项目(2014CFB153)
