不同方式的血液净化治疗对尿毒症患者皮肤瘙痒及生活质量的影响研究

Effect of different blood purification modes on skin pruritus and quality of life in uremic patients

目的探讨不同血液净化模式对尿毒症患者皮肤瘙痒及生活质量的影响。方法将2014年1月至2016年3月期间于本院行血液净化治疗的72例患者纳入研究,随机均等分到血液透析(HD)组和高通量血液透析组(HFHD),两组患者分别接受不同的血液净化。记录和对比两组患者接受研究前后的一般资料、生化指标、皮肤瘙痒情况和SF-36量表具体评分,评价不同血液净化方式治疗后患者皮肤瘙痒和生活质量的改善情况。结果在接受治疗超过6个月后,两组患者的血清肌酐(Cr)和尿素氮(BUN)差异无统计学意义(P>0.05),HFHD组患者的甲状旁腺激素(PTH)、β2-微球蛋白(β2-MG)和血磷(P)明显低于HD组,皮肤瘙痒改善情况优于HD组,生活质量优于HD组,差异有统计学意义(P<0.05)。结论常规血液透析和高通量血液透析对小分子物质有相同的清除功效,高通量血液透析对中、大分子物质的清除优于常规血液透析,对改善皮肤瘙痒和提高生活质量有更好的效果。

Objective To investigate the effect of different blood purification modes on the skin pruritus and quality of life in uremic patients. Methods A total of 72 patients who underwent hemopurification between January 2014 and March 2016 were randomized equally into the hemodialysis （HD） group and the high- throughput hemodialysis group （HFHD）. Patients in the two groups were treated with different blood purification. The general data, biochemical indexes, skin itching and the score of SF-36 evaluation scale of two groups patients before and after the study were recorded and contrasted, to evaluate the effect of different blood purification modes on the skin pruritus and quality of life. Results In more than 6 months after the treatment, the serum creatinine and urea nitrogen between the two groups had no statistical significance difference （P〉0.05）. The concentration of parathyroid hormone, 132-microglobulin and blood phosphorus of high flux hemodialysis group was significantly lower than that of hemodialysis group; the improvement of skin itching was better than those in hemodialysis group; and the scores of physiological function were higher than those in hemodialysis group, and the difference was statistically significant （P〈 0. 05 ）. Conclusions Hemodialysis and high flux hemodialysis have the same effect on the removal of small molecules, while high flux hemodialysis has stronger effect on the removal of medium and large molecular substances, which can better the skin itching and the quality of life.