血液透析联合血液灌流对维持性血液透析患者营养方面的优势

Effet of hemodialysis combined with hemoperfusion on nutritional status in maintenance hemodialysis patients

目的探讨血液透析(hemodialysis,HD)联合血液灌流(hemodialysis,HP)对维持性HD患者的营养状况的影响。方法选择维持性HD的终末期患者40例,随机分为2组:HD联合HP组(HD+HP组)和单纯HD组(HD组),每组各20例,分别于治疗前和治疗后3个月采血,全自动生化仪检测血红蛋白(hemoglobin,Hb),放射免疫法检测血浆瘦素(leptin)。结果治疗前,HD组与HD+HP组治疗前血红蛋白(hemoglobin,Hb)、血浆瘦素(leptin)水平差异均无统计学意义(P>0.05)。治疗后:(1)Hb水平两组较治疗前均有升高(P<0.05),HD联合HP组较单纯HD组升高更明显(P<0.01);(2)单纯HD组血瘦素(leptin)水平较治疗前无明显改变(P>0.05),HD+HP组治疗后血瘦素(leptin)明显下降(P<0.01)。结论 HD联合HP组能够全面清除终末期肾病HD患者体内毒素,能更好的改善患者贫血和营养状况,对提高患者的生存质量和生存期具有重要的意义。

Objective To investigate the hemodialysis (hemodialysis ,HD) combined with hemoperfusion (hemodialysis ,HP) effects on nutri-tional status in maintenance of HD patients .Methods We collected 40 end-stage renal disease (ESRD) patients on hemodialysis ,and randomly di-vided into tow groups :hemoperfusion combined with hemodialysis group HD HP group (n=20 ,HD+ HP group) and simple hemodialysis group (n=20 ,HD group) .Before and after treatment for 3 months ,hemoglobin(Hb)were measured on a biochemistry ,and plasma leptin were determined by radioimmunoassay .Results No significant differences in Hb ,leptin were found between the two groups before treatment (P>0.05) .After the treatment ,Hb level were higher in two groups ,but ,Hb level were higher in HD+ HP group zhan in HD group .However ,leptin the lever were not differet in HD group(P>0.05);leptin the lever were lower in HD+ HP group(P<0.05) .Conclusion HD combined with HP can improve the nu-tritional .status of the patients ,and is better than simple HD group ,has clinical value .