不同透析模式对维持性血液透析患者残肾功能血脂及毒素的系统影响评价

System of different dialysis modes on maintenance hemodialysis residual renal function in dialysis patients and blood fat and toxin effect evaluation

目的系统评价不同透析模式对维持性血透患者残余肾功能、血脂及大中分子毒素的影响。方法检索国内主要数据库,收集不同透析模式,即高通量透析(HFHD)、低通量透析(LFHD)、血液透析联合血液灌流(HD+HP)对维持性血透患者残肾功能(RRF)影响的随机对照试验,使用循证医学软件进行Meta分析。结果共纳入9个研究,899例患者。Meta分析结果显示:1HFHD和HD+HP在保护RRF上优于LFHD,而HFHD与HD+HP在此方面差异无统计学意义[WMD=-0.25,95%CI(-0.62,0.13)];2HFHD和HD+HP在降低血脂、β2微球蛋白和血磷方面优于LFHD,HFHD和HD+HP差异无统计学意义(P<0.05)。结论对于维持性透析患者,与LFHD比,HFHD及HD+HP能更好地保护RRF,降低血脂、β2微球蛋白及血磷水平。

Objective To evaluate the effects of different hemodialysis on maintenance hemodialysis patients with residual renal function,blood lipids and large molecular toxin. Methods The main database was retrieve and different dialysis modes were collected：high flux hemodialysis（ HFHD） and low flux hemodialysis（ LFHD） and hemodialysis combined with hemoperfusion（ HD ＋ HP） on maintenance hemodialysis（ maintenance hemodialysis,MHD） in patients with residual renal function（ RRF） of random controlled trials and quasi randomized controlled trials of the effects. The use of meta based software analysis related medicine. Results A total of 9 studies were included in 899 cases. The results of meta analysis showed that HFHD and HD ＋ HP were superior to those in protection RRF LFHD; and HFHD and HD ＋ HP in this,there was no difference between WMD =- 0. 25 95% CI（- 0. 62,0. 13）; the HFHD and HD ＋HP in reducing blood lipids,beta 2 microglobulin andphosphorus was better than that of LFHD; HFHD and HD ＋ HP no significant difference. Conclusion When patients with maintenance hemodialysis,and the ratio of LFHD,HFHD and HD ＋ HP can protect RRF,lower blood lipids,beta 2 microglobulin and blood phosphorus level.