高通量血液透析在维持性血液透析终末期慢性肾脏病患者中的应用价值

Application of high-flux hemodialysis in patients with end-stage chronic kidney disease undergoing maintenance hemodialysis

目的探讨高通量血液透析(HFHD)在维持性血液透析(MHD)终末期慢性肾脏病患者中的应用价值。方法选取2018年9月至2021年2月在河南大学第一附属医院进行MHD的终末期慢性肾脏病患者92例为研究对象。按照随机数字表法分为对照组与试验组,每组46例。对照组采用低通量血液透析(LFHD)治疗,试验组采用HFHD治疗。比较两组疗效、炎症因子[超敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)]水平、肾功能[尿素氮(BUN)、血肌酐(Scr)]水平及并发症发生率。结果治疗后,试验组治疗总有效率(93.48%,43/46)较对照组(71.74%,33/46)高,差异有统计学意义(χ^(2)=7.566,P=0.006<0.05)。治疗后,试验组hs-CRP、IL-6水平低于对照组,差异有统计学意义(P<0.05)。治疗后,试验组BUN、Scr水平低于对照组,差异有统计学意义(P<0.05)。试验组低血压发生率(4.3%,2/46)与对照组(13.04%,6/46)比较,差异未见统计学意义(P>0.05)。试验组高血压发生率(10.87%,5/46)、心律失常发生率(4.35%,2/46)均较对照组高血压发生率(28.26%,13/46)、心律失常发生率(19.57%,9/46)低,差异有统计学意义(P<0.05)。结论HFHD应用于MHD终末期慢性肾脏病治疗中能提高疗效,可缓解机体炎症,改善患者肾功能,降低并发症发生率。

Objective To investigate the application value of high throughput hemodialysis(HFHD)in patients with end-stage chronic kidney disease after maintenance hemodialysis(MHD).Methods Ninty-two patients with end-stage chronic kidney disease who underwent MHD in the First Affiliated Hospital of Henan University from September 2018 to February 2021 were selected as the study subjects.According to the method of random number table,they were divided into control group and test group,with 46 cases in each group.The control group was treated with low flux hemodialysis(LFHD),and the test group was treated with HFHD.The curative effect,the levels of inflammatory factors[hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6)],renal function[urea nitrogen(BUN),serum creatinine(Scr)]and the incidence of complications were compared between the two groups.Results After treatment,the total effective rate of treatment in the test group(93.48%,43/46)was higher than that in the control group(71.74%,33/46),and the difference was significant(χ^(2)=7.566,P=0.006<0.05).After treatment,the levels of hs-CRP and IL-6 in the test group were significantly lower than those in the control group(P<0.05).After treatment,the levels of BUN and Scr in the test group were lower than those in the control group,and the differences were significant(P<0.05).There was no significant difference in the incidence of hypotension between the test group(4.3%,2/46)and the control group(13.04%,6/46)(P>0.05).The incidences of hypertension(10.87%,5/46)and arrhythmia(4.35%,2/46)in the test group were lower than those in the control group(28.26%,13/46 and 19.57%,9/46),with significant differences(P<0.05).Conclusions The application of HFHD in the treatment of MHD end-stage chronic kidney disease can improve the curative effect,alleviate the inflammation,improve the renal function and reduce the incidence of complications.