摘要
目的 探讨高通量透析联合血液灌流对老年维持性血液透析(MHD)患者残余肾功能(RRF)及免疫功能的影响。方法 选择2020年12月至2022年12月周口市中心医院收治的96例老年MHD患者,随机分为对照组和研究组各48例。对照组患者接受高通量透析治疗,研究组患者接受高通量透析联合血液灌流治疗,对比两组血清钙、磷及甲状旁腺激素(iPTH)水平、RRF、免疫功能[免疫球蛋白(IgG、IgM)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)]及不良反应。结果 透析3个月后,两组钙水平升高,磷、iPTH水平降低(P<0.05);且研究组钙水平高于对照组,磷、iPTH水平低于对照组(P<0.05)。透析3个月后,两组RRF水平下降(P<0.05);研究组RRF水平高于对照组(P<0.05)。透析3个月后,两组CD4^(+)、CD4^(+)/CD8^(+)、IgG、IgM水平升高,CD8^(+)水平降低(P<0.05);且研究组CD4^(+)、CD4^(+)/CD8^(+)、IgG、IgM水平高于对照组,CD8^(+)水平低于对照组(P<0.05)。两组不良反应发生率对比差异无统计学意义(P>0.05)。结论 高通量透析联合血液灌流可有效调节老年MHD患者钙、磷及iPTH水平,促进免疫功能恢复,同时维护RRF,且不增加不良反应,是一种安全可靠的治疗方案。
Objective To investigate the effects of high throughput dialysis combined with hemoperfusion on residual renal function(RRF)and immune function in elderly maintenance hemodialysis(MHD)patients.Methods A total of 96 elderly MHD patients admitted to Zhoukou Central Hospital from December 2020 to December 2022 were randomly divided into control group and study group with 48 cases each.Patients in the control group received high-throughput dialysis treatment,and patients in the study group received high-throughput dialysis combined with hemoperfusion treatment.Serum calcium,phosphorus and parathyroid hormone(iPTH)levels,RRF,immune function[immunoglobulin(IgG,IgM),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)]and adverse reactions were compared between the two groups.Results After 3 months of dialysis,calcium level increased,phosphorus,iPTH level decreased(P<0.05).The levels of calcium in the study group were higher than those in the control group,and the levels of phosphorus and iPTH were lower than those in the control group(P<0.05).After 3 months of dialysis,RRF levels in both groups decreased(P<0.05).The RRF level of the study group was higher than that of the control group(P<0.05).After 3 months of dialysis,the levels of CD4^(+),CD4^(+)/CD8^(+),IgG and IgM were increased,while the levels of CD8^(+)were decreased(P<0.05).The levels of CD4^(+),CD4^(+)/CD8^(+),IgG and IgM in the study group were higher than those in the control group,and the levels of CD8^(+)were lower than those in the control group(P<0.05).There was no difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion High throughput dialysis combined with hemoperfusion can effectively regulate the levels of calcium,phosphorus and iPTH in elderly MHD patients,promote the recovery of immune function,maintain RRF,and do not increase adverse reactions.It is a safe and reliable treatment plan.
作者
宋秀丽
李琳琳
麻世静
SONG Xiuli;LI Linlin;MA Shijing(Department of Nephrology,Zhoukou Central Hospital,Zhoukou 466000,China)
出处
《河南医学研究》
CAS
2024年第3期473-476,共4页
Henan Medical Research
关键词
高通量透析
血液灌流
老年
维持性血液透析
肾功能
免疫功能
high flux dialysis
hemoperfusion
elderly
maintenance hemodialysis
renal function
immune function
