三种血液净化方式对终末期肾功能衰竭患者血清中分子毒素的清除疗效对比

Comparative Analysis of the Efficacy of Three Blood Purification Methods in the Clearance of Serum Molecular Toxins in Patients with end-stage Renal Failure

目的研究分析三种血液净化方式对终末期肾功能衰竭患者血清中分子毒素的清除疗效情况。方法将我院在2016年3月至2017年3月期间收治的70例终末期肾功能衰竭患者作为研究对象,采用随机数字表法将其分为三组,分比为透析组(23例)、血滤组(23例)及灌流组(24例),三组患者均进行常规的血液透析治疗,其中透析组继续血液透析治疗,血滤组实行在常规基础上另加血液透析滤过治疗,灌流组在血液透析治疗的基础上联合血液灌溉治疗,每周均治疗一次,治疗2个月,采用放射免疫法测定血清中分子毒素的β2-微球蛋白指标,然后对比三组患者治疗前后的凝血指标情况。结果治疗前,三组患者各凝血指标无显著差异(P> 0.05),治疗后,三组患者的凝血指标较治疗前均有差异,且灌流组的变化明显优于透析组和血滤组(P <0.05);血滤组与灌流组患者治疗后较治疗前β2-微球蛋白血浓度下降(P <0.05),血滤组与灌流组患者治疗后与透析组β2-微球蛋白血浓度有明显差异,其中灌流组的下降幅度最为明显(P <0.05)。结论相比血液透析或血液透析滤过,血液灌流更能有效的清除患者血液中的中分子毒素,且对终末期肾功能衰竭患者的临床疗效更显著,能有效的改善患者的凝血因子,更具安全性。

Objective To study the effect of three blood purification methods on the clearance of molecular toxin in serum of patients with end-stage renal failure.Methods 70 eases of end-stage renal failure treated-in our hospital from March 2016 to-March 2017 were treated in our hospital from March 2016 to March 2017.Patients with renal failure,The patients were randomly divided into three groups:dialysis group (n=23 ),hemofiltration group (n=23 )and peffusion group (n=24 ).The hemofiltration group was treated with hemodiafiltration on a routine basis,and the hemodialysis group was treated with hemodialysis On the basis of combined blood irrigation therapy,once a week for 2 months,the β2-mieroglobulin index of molecular toxin in serum was measured by radioimmunoassay.Results Before and after treatment,there was no significant difference in coagulation indexes between the three groups (P >0.05 ).After treatment,the coagulation indexes of the three groups were all different compared with those before treatment.The change in perfusion group was significantly better than that in dialysis group and hemofiltration group (P <0.05 ),and the blood concentration of β2-mieroglobulin in hemofiltration group and perfusion group was lower than that before treatment (P <0.05 )..Conclusion Compared with hemodialysis or hemodiafiltration,the blood concentration of β_2-mieroglobulin in the peffusion group is the most significant.Hemoperfusion can effectively clear the blood of the patients with middle molecular toxin,and the clinical efficacy of end-stage renal failure patients is more significant,can effectively improve the coagulation factors.