血液透析联合血液灌流治疗尿毒症性顽固性心力衰竭的疗效

Therapeutic effect of hemodialysis combined with hemoperfusion in treatment of uremic patients with refractory heart failure

目的探讨血液透析联合血液灌流治疗尿毒症性顽固性心力衰竭的疗效。方法选择血液透析并发尿毒症顽固性心力衰竭的患者64例，随机将其分为治疗组和对照组，每组32例。对照组采用血液透析，治疗组采用血液透析加血液灌流，连续治疗3次。结果两组的疗效、心功能指标、血中中分子物质（Middle molecular substances，MMS）含量的差异具有统计学意义；治疗组各疗效段MMS的含量差异显著。结论1、血液透析联合血液灌流能有效控制尿毒症性顽固性心力衰竭；2、尿毒症性顽固性心力衰竭患者血中MMS含量与心衰的严重程度密切相关，血液透析联合血液灌流能有效降低MMS浓度。

Objective To explore the effect of hemodialysis combined with hemoperfusion in treatment of uremic patients with refractory cardiac failure. Method 64 uremic patients on hemodialysis and with refractory heart failure were randomly divided into treatment group and control group （each group 32 cases）. Control group subjected to hemodialysis while treatment group underwent hemodialysis combined with hemoperfusion treatment for 3 time successively. Results The therapeutic effect, cardiac index, content of blood middle molecular substances（MMS） of 2 groups showed statistic differences. There were significant differences of MMS contents in varions phases of treatment group. Conclusions （1） HD combined with HP can effectively control refractory heart failure in uremia. （2） There is close relationship between MMS content and severity of heart failure in uremia. （3） HD combined with HP can reduce the concentration of MMS.