血液透析与腹膜透析治疗糖尿病肾病疗效观察

Clinical Study of Hemodialysis and Peritoneal Dialysis in Treatment of Diabetic Nephropathy in End-Stage

目的:比较终末期糖尿病肾病采用血液透析(HD)和腹膜透析(CAPD)治疗的临床疗效。方法:选取60例终末期糖尿病肾病患者,将其随机分为HD组33例和CAPD组27例,观察两组患者透析治疗1年后的体重、肾功能、血红蛋白、总蛋白、白蛋白、血糖、血钾、尿量、血压等。结果:透析后HD组肌酐、血尿素氮、尿量下降更为明显;HD组白蛋白相对较为稳定,透析前、后比较差异无统计学意义(P>0.05);而CAPD组白蛋白明显下降,差异有统计学意义(P<0.05);CAPD血压控制较HD组好,两组血糖水平透析前后比较差异均无统计学意义(P>0.05)。结论:HD和CAPD是治疗终末期糖尿病肾病的两种有效方式,对糖尿病肾病患者,根据其不同的适应证采用血液透析或腹膜透析个体化治疗,进而有效提高其生活及生存质量。

Objective. To investigate the clinical effect of HD and CAPD in the treatment of patients with Diabetic Nephropathy in end-stage. Methods ： 60 patients with diabetic nephropathy in end-stage were divided into two groups according they received differ- ent treatment. Including the H D group （n= 33） received hemodialysis treatment and CAPD group （n= 27） received continuous am- bulatory peritoneal dialysis treatment. Their clinical data including body weight, renal function, hemoglobin, total protein, albumin, blood glucose,blood potassium,urine volume and blood pressure were analyzed and studied contrastively. Results：After dialysis, creatinine, blood urea nitrogen, urinary volume decreased more obviously, and albumin is relatively stable, there was no significantly difference before and after dialysis （P〉0.05） in HD group. While albumin decreased significantly in the CAPD group（P〈0.05）. the blood pressure of CAPD group control was better than that of HD group, there was no significant difference in two groups before and after blood glucose levels in dialysis （P〉0.05）. Conclusion： HD and CAPD in the treatment of diabetic nephropathy is two kinds of effective way,the proper choice and the inter change of the way s of reneal replace treatment,are perhaps useful to improve the survival rate of the patients with diabetic nephropathy in end-stage.