血液透析串联血液灌流与血液透析滤过疗效对比

Differences of therapeutic efficacy between hemoperfusion associated with hemodialysis and hemodiafiltration

目的:观察血液灌流+血液透析(HP+HD)与血液透析滤过(HDF)对维持性血透(MHD)患者对大分子物质清除作用以及对患者营养状态和生活质量的影响。方法:选取复旦大学附属金山医院肾内科血透室MHD患者60例,随机分为HDF组和(HP+HD)组,每组30例。检测瘦素(Leptin)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和C反应蛋白(CRP)等水平,计算上述各分子下降率,评估患者营养状况、生活质量,对比两组间差异。结果:(HP+HD)组Leptin、IL-6及TNF-α清除率高于HDF组。治疗6个月后,(HP+HD)组患者炎症标志物IL-6、TNF-α、CRP水平均显著低于HDF组,且营养状态及生活质量优于HDF组。结论:HP+HD可以有效降低大分子物质水平,减轻炎症状态,改善营养状态及生活质量。

Objective： To observe the effects of hemoperfusion combined with hemodialysis（HP＋ HD）and hemodiafiltration（HDF）on the macro-molecules and quality of life and nutritional status of maintenance hemodialysis（MHD）patients.Methods：Sixty patients undergoing MHD were selected and randomly divided into HDF group and（HP＋ HD）group,with 30 cases in each group.The Leptin,interleukin-6（IL-6）,tumor necrosis factor-α（TNF-α）and CRP level were detected.The reduction rates of each molecule were calculated,the nutritional status and quality of life of patients were evaluated,and the differences between two groups were compared.Results：The clearance rates of Leptin,IL-6,and TNF-αin（HP＋HD）group were higher than which in HDF group.After 6 months of treatment,the inflammatory markers of IL-6,TNF-αand CRP in（HP＋HD）group were significantly lower than which in HDF group,and the nutritional status and quality of life were better than HDF group as well.Conclusions： HP＋ HD can effectively reduce the level of macro-molecules,alleviate inflammatory status,improve nutritional status and quality of life.