摘要
目的探讨腹膜透析与高通量血液透析对终末期肾病(ESRD)患者心功能、炎症因子及免疫指标的影响。方法选取2019年8月至2020年8月琼海市人民医院102例终末期肾病患者作为研究对象,按照随机数字表法分为观察组(予以腹膜透析)与对照组(予以高通量血液透析)各51例,对比肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)、超敏C-反应蛋白(hs-CRP)、CD4^(+)、CD3^(+)、CD8^(+)、CD4^(+)/CD8^(+)。评估左室后壁厚度(LVPWTd)、舒张末期室间隔厚度(IVSTd),在心尖四腔切面测定左室射血分数(LVEF)、左室舒展末期容积(LVEDV)、左室收缩末期容积(LVESV)。观察并发症发生情况,包括感染、充血性心力衰竭等。结果透析后,观察组的LVPWTd、IVSTd、LVEDV、LVESV、hs-CRP、TNF-α、IL-6、CD8^(+)低于对照组,而LVEF、CD4^(+)、CD3^(+)、CD4^(+)/CD8^(+)高于对照组(P<0.05)。观察组充血性心力衰竭低于对照组(P<0.05),2组感染发生率比较,差异无统计学意义(P>0.05)。结论腹膜透析与高通量血液透析用于终末期肾病患者中均具有一定疗效,其中腹膜透析改善效果优于高通量血液透析,且对心功能及其结构影响更小。
Objective To investigate the effects of peritoneal dialysis and high flux hemodialysis on cardiac function,inflammatory factors and immune indexes in the patients with end‐stage renal disease(ESRD).Methods A total of 102 patients with ESRD who sought medical care from August 2019 to August 2020 were selected as research subjects in Qionghai People’s Hospital,and were randomly divided into the observation group(with peritoneal dialysis)and the control group(with high flux hemodialysis),each consisting of 51.The levels of tumor necrosis factorα(TNF‐α),interleukin‐6(IL‐6),high‐sensitivity C‐reactive protein(hs‐CRP),CD4^(+),CD3^(+),CD8^(+)and CD4^(+)/CD8^(+)were compared between the 2 groups.Left ventricular posterior wall thickness(LVPWTd),interventricular septum diastolic thickness diameter(IVSTd),left ventricular ejection fraction(LVEF),left ventricular end‐diastolic volume(LVEDV)and left ventricular end‐systolic volume(LVESV)were evaluated in apical four‐chamber view.Observations were also made on such symptoms as infection,peritonitis,hypoalbuminemia,congestive heart failure etc.Results After dialysis,the levels of LVPWTd,IVSTd,LVEDV,LVESV,hs‐CRP,TNF‐α,IL‐6 and CD8^(+)in the observation group were lower than those of the control group,while the levels of LVEF,CD4^(+),CD3^(+),CD4^(+)/CD8^(+)were higher than those in the control group(P<0.05).The rate of congestive heart failure in the observation group was lower than that in the control group,and no statistical significance could be seen,when comparisons were made between the 2 groups(P>0.05).Conclusion Both peritoneal dialysis and high‐flux hemodialysis could achieve certain curative effects in the patients with end‐stage renal disease,with the effects of peritoneal dialysis being more obvious,and having less impacts on cardiac function and heart structure.
作者
王捷
何华妮
吴伟
王克坤
Wang Jie;He Huani;Wu Wei;Wang Kekun(Department of Nephrology,Qionghai People’s Hospital,Qionghai 571400,China)
出处
《海军医学杂志》
2023年第2期141-145,共5页
Journal of Navy Medicine
基金
海南省卫生计生行业科研项目(19A200052)。
关键词
腹膜透析
高通量血液透析
终末期肾病
心功能
炎症因子
免疫指标
Peritoneal dialysis
High flux hemodialysis
End‐stage renal disease
Cardiac function
Inflammatory factor
Immune indicator
