血液透析联合血液灌流对维持性透析患者认知功能的影响

Hemodialyis in combination with hemoperfusion improving the cognitive ability of patients receiving maintenance dialysis

目的对比血液灌流联合血液透析(简称血灌)、血液透析(简称血透)对维持性透析患者认知功能影响的差异。方法选择50例须行维持性透析的终末期肾功能衰竭(End Stage Renal Disease,ESRD)患者,将其分为血灌组(26例)和血透组(24例),分别测定两组治疗前、治疗1个月及6个月后事件相关电位P300(简称P300)的潜伏期、波幅及简易智能精神状态量表(MMSE)评分。结果治疗前、治疗1个月后血灌组和血透组P300潜伏期和波幅,差异均无显著性(P均>0.05);治疗6个月后两组P300潜伏期和波幅分别为(315.6±31.9)ms、(8.9±1.15)μV和(341.8±33.5)ms、(8.03±1.01)μV,差异有高度显著性(P<0.01)。血灌组和血透组治疗前、治疗1个月后MMSE评分,差异均无显著性(P均>0.05),治疗6个月后两组MMSE评分分别为(27.9±2.3)分和(25.6±1.9)分,差异有高度显著性(P<0.01)。结论不同透析方式对维持性透析患者远期认知功能有明显影响,血液灌流联合血液透析对持续改善维持性透析患者认知功能可能较常规血液透析好。

Objective To compare of different results in improving the cognitive ability of patients receiving maintenance dialysis between hemodialyis in combination with hemoperfusion （HP） and single hemodialyis （HD）. Methods 50 patients with end stage renal disease （ESRD） needed maintenance dialysis were randomly divided into HP group （ n =26） and HD group （ n = 24）. Before treatment, 1 and 6 months after treatment, latency period of event-related potentials P300 （P300）, wave amplitude and the scores of mini-mental state examination （MMSE） were measured. Results Before treatment and 1 month after treatment, compared HP group to HD group, results showed no differences in latency period of P300 and wave amplitude （ P 〉0.05）. 6 months after treatment, latency of P300 and wave amplitude in HP group and HD group were （315.6 ± 31.9）ms, （8.9 ± 1.15）μV and （341.8 ± 33. 5）ms, （8.03 ± 1.01）μV, respectively, there were statistically significant differences （ P 〈0.01）. Before treatment and 1 month after treatment, compared liP group and HD group, results showed no difference in MMSE scores （ P 〉0.05） ; 6 months after treatment, MMSE scores in the two groups were （27.9± 2.3） and （25.6 ± 1.9）, there was statistically significant difference （ P 〈0.01）. Conclusion Different dialysis has obvious influence on cognitive ability of patients with maintenance dialysis, hemoperfusion in combination with hemodialysis is superior to conventional hemodialysis in improving the patients＇ cognitive capability.