不同时机血液灌流联合血液透析对尿毒症患者肾功能及中高分子毒素水平的影响

Effects of hemoperfusion combined with hemodialysis at different times on renal functions and the levels of medium and high molecular toxins in uremia patients

目的 分析不同时机血液灌流(HP)联合血液透析(HD)对尿毒症患者肾功能及中高分子毒素水平的影响。方法 选取贵州省天柱县人民医院2018年9月—2020年10月收治的96例尿毒症患者,按随机数字表分为对照组、观察组,各48例。两组均行HD治疗,对照组采用HP前置方案治疗,观察组采用HP后置方案治疗,治疗周期为3个月;比较两组肾功能指标[尿素氮(BUN)、血肌酐(Scr)、尿酸(UA)]、中高分子毒素[全段甲状旁腺激素(iPTH)、β微球蛋白(β-MG)]水平及营养状况指标[血红蛋白(Hb)、血清白蛋白(ALB)]。结果 观察组治疗3个月后BUN、Scr、UA、iPTH、β-MG水平均低于对照组,Hb、ALB水平均高于对照组,差异有统计学意义(P<0.001)。结论 相比HP前置治疗,尿毒症患者采用HP后置联合HD治疗更利于改善肾功能,降低中高分子毒素水平,提高营养状况。

Objective To analyze the effects of hemoperfusion(HP) combined with hemodialysis(HD) at different times on renal functions and the levels of medium and high molecular toxins in uremia patients. Methods A total of 96 uremia patients admitted to People’s Hospital of Tianzhu County from September 2018 to October 2020 were selected and divided into control group and observation group according to random number table, with 48 cases in each group. Both groups were treated with HD. The control group were given HP pre-treatment, and the observation group were given HP post-treatment, and both groups were treated for 3 months. And then, renal function indexes(blood urea nitrogen[BUN], serum creatinine[Scr], uric acid [UA]), the levels of medium and high molecular toxins(intact parathyroid hormone [iPTH], β-microglobulin[β-MG]) and nutritional status indexes(hemoglobin[Hb], serum albumin[ALB]) were compared between the two groups. Results 3 months after treatment, the levels of BUN, Scr, UA, iPTH and β-MG in the observation group were lower than those in the control group, the levels of Hb and ALB were higher than those of the control group, and difference was statistically significant(P<0.001). Conclusion Compared with HP pre-treatment, HP post-treatment combined with HD therapy is more beneficial to improve renal functions, reduce the levels of medium and high molecular toxins, and improve nutritional status in uremia patients.