高通量透析器用于维持性血液透析患者的效果

Efficacy of high-flux dialyzers for hemodialysis patients

目的分析高通量透析器用于维持性血液透析患者的疗效。方法选取2014年3-7月梅州市丰顺县人民医院收治的12例尿毒症并行维持性透析治疗的患者,分为实验组（6例）和对照组（6例）,对照组给予常规血液透析器进行透析,实验组给予高通量透析器进行透析。治疗3个月后对比分析两组的β2-微球蛋白含量、白蛋白含量、肌酐和尿素氮含量及健康调查简表（SF-36）评分。结果治疗3个月后,实验组和对照组β2-微球蛋白含量和血浆白蛋白含量与治疗前比较,差异有统计学意义（P〈0.05）;且实验组改善程度优于对照组,差异有统计学意义（P〈0.05）[实验组（14.50±3.99）mg/L、（38.02±1.03）g/L比对照组（19.47±2.97）mg/L、（34.99±2.28）g/L]。肌酐和尿素氮含量在治疗前后及组间比较,差异均无统计学意义（P〉0.05）。经过治疗,实验组患者的生理功能、生理职能、躯体疼痛、总体健康、情感角色、心理健康得分显著高于对照组[实验组（31.02±2.99）、（4.99±0.82）、（8.69±1.42）、（11.99±0.28）、（4.99±1.28）、（25.11±2.98）分比对照组（26.11±3.02）、（4.43±0.72）、（8.31±1.02）、（10.27±2.11）、（4.53±0.99）、（22.09±3.11）分],差异有高度统计学意义（P〈0.01）;而活力、社会功能得分治疗前后及两组间比较,差异均无统计学意义（P〉0.05）。结论与常规血液透析器相比,高通量透析器用于治疗维持性血液透析患者可显著提高患者β2-微球蛋白的清除率,改善机体营养指标,维持肾功能稳定,有重要的临床应用价值。

Objective To study the efficacy of high-flux dialyzers for hemodialysis patients. Methods From March to July 2014, in People＇s Hospital of Fengshun County in Meizhou City, 12 patients with uremia and given nephrology parallel maintenance dialysis therapy were selected and divided into experimental group（6 cases） and control group（6 cases）. The control group was given conventional hemodialysis dialysis unit, the experimental group was given high-flux dialyzers dialysis. After 3 months＇ treatment, the β2-microglobulin, albumin, creatinine and urea nitrogen and SF-36 scores of the two groups were compared and analyzed. Results After 3 months treatment, the β2-microglobulin and albumin two groups were compared with those before the treatment, the differences were statistically significant（P 〈0.05）;and these in experimental group were better than those in control group [experimental group（14.50±3.99） mg/L,（38.02±1.03） g/L vs control group（19.47±2.97） mg/L,（34.99±2.28） g/L], the differences were statistically significant（P 〈0.05）.But creatinine and urea nitrogen content between the two groups before and after the treatment had no statistically significant difference（P 〉0.05）. After the treatment, the scores of physiological function, role physical, body pain, general health, role emotional, psychological health in SF-60 of experimental group were higher than those of control group[experimental group（31.02±2.99）,（4.99±0.82）,（8.69 ±1.42）,（11.99 ±0.28）,（4.99 ±1.28）,（25.11 ±2.98） scores vs control group（26.11±3.02）,（4.43±0.72）,（8.31±1.02）,（10.27±2.11）,（4.53±0.99）,（22.09±3.11） scores], the differences were statistically significant（P 〈0.05）. But vitality, social function in two groups before and after the treatment were compared,and those in two groups after the treatment were compared, the differences were not statistically significant（P 〉0.05）.Conclusion Compared with conventional hemodialysis, high-flux dialyzers for hemodialysis patients on maintenance therapy can significantly improve patient β2-microglobulin clearance rate, improve the nutritional indicators, maintaining stable renal function has important clinical value.