连续性肾脏替代疗法对尿毒症脑病患者中分子毒素的清除效果分析

The Effect of Continuous Renal Replacement Therapy on the Removal of Middle Molecular Toxins in Patients with Uremic Encephalopathy

目的 研究连续性肾脏替代疗法对尿毒症脑病患者中分子毒素的清除效果.方法 随机抽取2013年8月—2015年1月该院收治的尿毒症脑病患者62例,按照随机数字表法随机分为对照组（n=30）和观察组（n=32）,所有患者均进行基础对症治疗,对照组给予普通血液透析治疗,观察组进行连续性静脉-静脉血液滤过治疗,持续治疗2周后观察对比两组患者治疗效果,并比较中分子毒素清除效果. 结果 观察组有效率93.8%显著高于对照组73.3%,差异有统计学意义 （χ2=4.77,P〈0.05）; 两组患者透析治疗后PTH、β2MG、BUN、Scr水平均显著下降, 差异有统计学意义 （P〈0.05）;观察组治疗后PTH、β2MG、BUN、Scr水平显著低于对照组,差异有统计学意义（P〈0.05）. 结论 采用连续性肾脏替代疗法能有效清除尿毒症脑病患者中分子毒素,临床效果好,值得推广.

Objective To study the effect of continuous renal replacement therapy on the removal of middle molecular toxins in patients with uremic encephalopathy. Methods 62 patients with uremic encephalopathy admitted into the hospital during August 2013 to January 2015 were selected and randomly divided to the control group （n=30） and the observation group （n=32） according to the random number table method. All the patients received primary symptomatic treatment. The control group were given common hemodialysis therapy while the observation group were treated with continuous veno-venous hemofiltration. The curative effect of the two groups were observed and compared after 2 weeks of continuous treatment and the effect of middle molecular toxin removal was compared. Results In the observation group, the effective rate was 93.8%, which was significantly higher than 73.3% in the control group and the difference was statistically significant （χ2=4.77, P〈0.05）. There was a significant decrease in PTH, β2MG, BUN and Scr levels of the two groups after dialytic treatment and the difference was statistically significant （P〈0.05）. After the treatment, PTH, β2MG, BUN and Scr levels of the observation group were significantly lower than those of the control group and the differences were statistically significant （P〈0.05）. Conclusion Continuous renal replacement therapy can effectively remove the middle molecular toxins in patients with ure-mic encephalopathy, and the clinical effect is good, which is worth promotion.