不同血液透析方式对维持性透析终末期肾功能衰竭患者认知功能的影响

Influence of different hemodialysis ways on cognitive function in the patients with end-stage renal failure in maintenance dialysis

目的探讨不同血液透析(简称透析)方式对维持性透析终末期肾功能衰竭(ESRF)患者认知功能的影响。方法选择68例需要进行维持性透析的ESRF患者,将其分为高通量透析组(高透析组)及常规量透析组(低透析组),每组34例;分别测定两组治疗前、治疗1个月及治疗6个月时P300的潜伏期(PL)和波幅(Amp)及简易精神状态检查量表(MMSE)评分。结果治疗前高透析组和低透析组P300PL和Amp分别为[(398.6±38.5)ms、(7.3±1.21)μV]和[(410.3±49.7)ms、(6.9±1.03)μV];治疗1个月时分别为[(336.8±32.1)ms、(8.2±1.15)μV]和[(342.6±35.8)ms、(7.9±1.01)μV],两组间比较差异无统计学意义;治疗6个月时分别为[(320.6±31.9)ms、(8.5±1.02)μV]和[(390.6±42.8)ms、(6.5±1.12)μV],两组间比较差异有统计学意义(均P<0.01)。高透析组、低透析组治疗前、治疗1个月后MMSE分别为(22.9±4.7)分、(23.3±4.5)分和(26.2±1.9)分、(25.9±1.8)分,两组间比较差异均无统计学意义;治疗6个月时两组MMSE分别为(27.1±3.6)分和(22.6±2.9)分,差异有统计学意义(P<0.01)。结论不同血液透析方式对需要进行维持性透析的ESRF患者远期认知功能有明显的影响;高透析量可持续改善ESRF患者的认知功能。

Objective To explore the influence of different hemodialysis ways on cognitive function in the patients with end-stage renal failure （ESRF） in maintenance dialysis. Methods Choosing 68 ESRF patients who needed maintenance dialysis were divided into high flux dialysis group and normal flux dialysis group ,34 eases in each group. The P300 lantency period （LP） and amplitude （Amp）, mini-mental status examination （MMSE） scale were applied to examine the patients in the.two groups before treatment, 1 month and 6 months after treatment, respectively. Results The P300 LP and Amp in high flux dialysis group and low flux dialysis group were （398.6 ±38.5） ms, （7.3 ± 1.21 ） μV vs （410.3± 49.7 ） ms, （6.9±1.03 ） μV before the treatment ; and （ 336.8 ± 32.1 ） ms, （8.2± 1.15 ） μV vs （342.6 ±35.8 ） ms, （7.9 ±1.01 ）μV 1 month after treatment. There were no significantly differences between the two groups. 6 months after treatment, the P300 LP and Amp of high flux dialysis group and low flux dialysis group were （ 320.6 ~ 31.9 ） ms, （ 8.5 ±.02 ） μV vs （ 390.6 ± 42.8 ） ms, （6.5 ±1.12 ） μV. There were significantly differences between the two groups （ all P 〈 0. 01 ）. The MMSE scores in the two groups before the treatment and 1 month after treatment were （22.9 ± 4.7） vs （23.3 ±4.5 ） and （26.2 ± 1.9 ） vs （ 25.9 ± 1.8 ）. There were no significantly differences between the two groups. But 6 months after treatment, the MMSE score in high flux dialysis group （27.1 ± 3.6 ） was significantly higher than that in low flux dialysis group （ 22.6 ± 2.9 ） （ P 〈 0. 01 ）. Conclusions Different hemodialysis ways have obvious effects on long-term cognitive function in ESRF patients who need maintenance dialysis. High flux dialysis can be sustainable improvement their cognitive function.