腹膜透析与血液透析患者肾性贫血治疗效果比较

Curative effectiveness of renal anemia during peritoneal dialysis vs. hemodialysis

目的比较腹膜透析（peritoneal dialysis，PD）与血液透析（hemodialysis，HD）患者肾性贫血的治疗效果。方法选择尿毒症行肾脏替代治疗患者90例，其中腹膜透析患者41例，血液透析患者49例。患者入组前1个月内均未行肾脏替代治疗、未使用促红细胞生成素（erythropoietin，EPO）、无失血；在肾脏替代治疗开始时加用EPO，比较腹膜透析组（PD组）和血液透析组（HD组）患者治疗前、治疗后第1、2、3个月血红蛋白（hemoglobin，Hb）的变化，以及PD组与HD组治疗后3个月超敏C反应蛋白（high sensitivity C reactive protein，hs—CRP）、血白蛋白（albumin，Alb）、尿素清除指数（Kt／V）的差异。结果治疗前2组的Hb值无统计学差异（P〉O．05或P〉0．01），治疗后第3个月2组的hs-CRP、Alb、Kt／V值无统计学差异（P〉0．05或P〉0．01）。透析治疗前后比较，PD组治疗后第1、2、3个月的Hb值均较治疗前升高（P〈0．05或P〈0．01），且治疗后第3个月〉第2个月〉第1个月；HD组治疗后第1、2、3个月的Hb值均较治疗前升高（P〈0．05或P〈0．01），且治疗后第3个月〉第2个月〉第1个月。PD组治疗后第1、2、3个月EPO的Hb值分别高于HD组，差异具有显著性（P〈0．01）。结论肾脏替代治疗、使用EPO可有效纠正尿毒症患者的肾I生贫血，PD患者使用EP0更有利于肾陛贫血的纠正。

Objective To compare the curative effectiveness of renal anemia during peritoneal dialysis （PD） vs. hemodialysis （HD）. Methods A total of 90 uremia patients were divided into two groups： PD group （n = 41） and HD group （n = 49）. At the beginning of the therapy, the patients were not treated with erythropoietin and had no bleeding. Patients in PDA group and HD group were treated with erythropoietin during the renal replacement therapy. The hemoglobin （Hb） levels both group were determined before, and at first,2nd and 3rd month after treatment. At third month after treat- ment, the high sensitivity C reactive protein （hs-CRP）, albumin （Alb）, and Kt/V in PD group and HD group were compared. Results There was no difference between the PD group and HD group in Hb levels before treatment. The Hb levels in the PD group and HD group were increased progressively af- ter dialysis for one month, two months and three months （P〈0. 05 or P〈0. 01） as compared with those before treatment. The Hb levels in PD group were significantly higher than in HD group after treatment for one month, two months and three months. There was no difference in hs-CRP, Alb and Kt/V between the PD group and HD group after dialysis for three months. Conclusions Erythropoie- tin can correct anemia in dialysis patients （including PD patients and HD patients）. The effect of PD is more significant than that of HD.