摘要
目的比较血液透析(HD)、血液透析联合血液灌流(HP+HD)、血液灌流+血液透析滤过(HP+HDF)3种不同的血液净化方式治疗终末期肾衰竭患者的慢性并发症的疗效。方法采用随机对照研究的方法选择180例尿毒症患者,先进行基础治疗,3组的治疗方案相同,然后再随机分为HD、HP+HD、HP+HDF 3组,各30例,治疗6个月。观察患者入组时及治疗6个月后的营养状态及并发症的发生率并采血检测相关指标:iPTH、β2微球蛋白(β2-MG)、瘦素、CRP、ALB、钙磷乘积、血常规等评价3种治疗方式的疗效及安全性。结果检测指标iPTH、β2微球蛋白(β2-MG)、瘦素、CRP、ALB对照组与实验组之间差异有统计学意义,就iPTH、CRP实验1组与实验2组无统计学差异,瘦素及β2-MG比较实验2组清除明显优于实验1组,差异有统计学意义,3组的血常规数据差异无统计学意义,实验期间未发生严重的不良反应。结论 HP+HD与HP+HDF均能缓解终末期肾衰竭患者的慢性并发症,HDF+HP对于清除中大分子毒素更为有效。
Objective Comparison of hemodialysis（HD） ,hcmodialysis combined with hemoperfusion（ HP ＋ HD） ,hemoperfusion and hemodiafiltration（ HP ＋ HDF） in 3 different ways of blood purification therapy for end - stage chronic complications in patients with end stage renal failure curative effect. Methods Randomized controlled trial using a choice of 180 uremic patients, before treatment, treatment for 3 groups of same, and then randomly divided into HD, HP ＋ HD, HP ＋ HDF 3 groups, each of 30 cases, treated for 6 months. Observation of patients and treatment on nutritional status and complications in 6 months after the occurrence rate and related indexes of blood testing： iPTH, beta 2 microglobulin （ 132 - MG）, leptin, CRP, ALB, calcium phosphorus product, blood routine to evaluate the safety and efficacy of 3 different treatment methods. Results The detection of target iPTH,beta 2 microglobulin（ 132 - MG） ,lep- tin, CRP, ALB between the control group and the experimental group had statistical significance,iPTH, CRP experimental group 1 and experimental group 2 showed no significant difference, leptin and β2 - MG 2 group was better than the comparison experiment of removal experiment group 1 ,there was significant difference, no significant difference in blood routine data of 3 groups,severe adverse reaction did not occur during the experiment. Conclusion HP ＋ HD and HP ＋ HDF can alleviate the chronic complications in patients with end stage renal failure, the HDF ＋ HP is more effective for removing toxin molecules.
出处
《哈尔滨医药》
2014年第2期99-100,102,共3页
Harbin Medical Journal
