不同血液净化方式对尿毒症患者血磷的清除作用及其影响因素

Effect of Different Blood Purification Methods on Serum Phosphorus Removal and Its Influencing Factors in Uremic Patients

目的探讨和分析不同血液净化方式对尿毒症患者血磷的清除作用及其影响因素,为尿毒症患者的临床治疗提供理论和实践参考。方法研究以2014年1月~2015年8月收治的93例尿毒症患者为研究对象,按照血液净化方式的不同,分为血液透析（HD）组、血液透析滤过（HDF）组以及高通量血液透析（HFHD）组,每组31例。通过静脉采血并分离血清,分别检测三组不同血液净化方式患者在治疗前及治疗结束6个月后血磷水平。结果三组患者在接受研究治疗前静脉血中血磷水平差异不显著,无统计学意义（P〉0.05）,经过6个月治疗后,HDF组和HFHD组患者静脉血中血磷水平均发生显著变化,差异均具有统计学意义（P〈0.05）,而HD组患者治疗前后静脉血中血磷水平差异不显著,无统计学意义（P〉0.05）。HDF组和HFHD组与HD组比较,患者静脉血中血磷水平差异显著,均具有统计学意义（P〈0.05）;HFHD组与HDF组比较,患者静脉血中血磷水平差异显著,均具有统计学意义（P〈0.05）。结论采用血液透析滤过和高通量血液透析两种不同血液净化方式均可以有效改善尿毒症患者体内高血磷症状,降低血磷水平,且高通量血液透析对血磷的的清除作用明显优于血液透析滤过。

Objective To factors scavenging effect on blood phosphorus in uremic patients to explore and analyze the different ways of blood purification and its effect,to provide theoretical and practical reference for the clinical treatment of uremic patients. Methods This study from January 2014 to August 2015 in 93 cases of uremic patients admitted to our hospital as the research object,according to blood purification methods different,divided into hemodialysis（ HD） group,hemodiafiltration（ HDF） group and high flux hemodialysis（ HFHD） group,31 cases in each group. The venous blood and serum were detected in three groups of different blood purification methods in patients with end serum phosphate level after 6 months before treatment and treatment. Results Three groups of patients in the treatment of different phosphorus levels before the venous blood is not significant,no statistical significance（ P 0. 05）,after 6 months of treatment,serum phosphorus level HDF group and HFHD group were significant in patients with venous blood Change,the differences were statistically significant（ P 0. 05）,but there was no significant difference in venous blood serum phosphorus level in HD group before and after treatment were not statistically significant（ P 0. 05）. HDF group and HFHD group and HD group,differences in serum phosphorus level in venous blood of patients with significant,with statistical significance（ P 0. 05）; HFHD group compared with HDF group,the difference of serum phosphorus levels in patients with venous blood significantly,were statistically significant（ P 0. 05）. Conclusions The hemodiafiltration and high flux hemodialysis in two different ways of blood purification can effectively improve urinary sepsis in patients with high the blood phosphorus symptoms,reduce serum phosphorus levels,and high flux hemodialysis on serum phosphorus removal effect of hemodiafiltration.