血液透析联合血液灌流改善慢性肾衰患者钙磷代谢紊乱的疗效观察

Effect of hemodialysis combined with blood perfusion on calcium and phosphorus metabolism disorder in patients with chronic renal failure

目的:观察分析血液透析联合血液灌流改善慢性肾衰患者钙磷代谢紊乱的疗效及IL-6、hs-CRP、TNF-α水平变化。方法:将104例慢性肾衰患者采用随机数表法分为血液透析组(HD组52例)与血液透析联合血液灌流组(HD+HP组52例),分别给予血液透析与血液透析联合血液灌流治疗。测定2组患者治疗6个月前、后血钙、血磷、钙磷乘积、iPTH水平、炎症因子水平(IL-6、hs-CRP、TNF-α)、BUN、Scr及ALB水平,并进行统计学分析。结果:治疗前2组患者血钙、血磷、钙磷乘积、iPTH水平、IL-6、hs-CRP、TNF-α水平、BUN、Scr、ALB水平比较差异均无统计学意义(P>0.05)。连续治疗6个月后,2组患者血钙无明显变化(P>0.05),血磷、钙磷乘积及iPTH水平明显降低,且HD+HP组明显低于HD组,差异有统计学意义(P<0.05)。连续治疗6个月,HD组患者炎症因子变化不明显,HD+HP组患者的IL-6、hs-CRP、TNF-α水平明显降低,且低于HD组,差异有统计学意义(P<0.05)。治疗6个月后,2组患者BUN、Scr水平明显降低,ALB水平明显升高,且HD+HP组患者BUN、Scr、ALB水平明显优于HD组,差异有统计学意义(P<0.05)。结论:血液透析联合血液灌流可明显改善慢性肾衰患者钙磷代谢紊乱,缓解炎症情况,有效控制肾功能、改善营养状况、有利于患者预后。

Objective：To study the effect of hemodialysis combined with blood perfusion on calcium and phosphorus metabolism disorder in the patients with chronic renal failure,and the changes of IL-6,hs-CRP and TNF-αlevel.Method：One hundred four cases of chronic renal failure patients were randomly divided into hemodialysis group（HD group=52cases）and hemodialysis combined with blood perfusion group（HD＋HP group=52cases）.They were respectively treated by hemodialysis and hemodialysis combined with blood perfusion.Calcium,serum phosphorus,calcium phosphorus product,iPTH levels,the level of inflammatory factors（IL-6,hs-CRP,TNF-α）,BUN,Scr and ALB level in the patients were measured before and after dialysis 6months and statistically analyzed.Result：Calcium,serum phosphorus,calcium phosphorus product,iPTH levels,the level of inflammatory factors（IL-6,hs-CRP,TNF-α）,BUN,Scr and ALB level of two groups had no significant difference（P〈0.05）.After 6months of treatment,serum calcium of the patients in the two groups had no significant change（P〈0.05）,serum phosphate,the product of calcium and phosphorus and iPTH levels of the HD＋HP group decreased significantly which were significantly lower than those of the HD group,the difference was statistically significant（P〈0.05）.After 6months of treatment,HD group patients had no significant changes in inflammatory factors,IL-6,hs-CRP and TNF-αlevels of the HD＋HP group were significantly lower,and lower than those of the HD group,the difference was statistically significant（P〈0.05）.Six months after treatment,BUN and Scr levels of the two groups were significantly lower,ALB levels were significantly higher,and BUN,Scr and ALB levels of the HD＋HP group were significantly better than those of the HD group,the difference was statistically significant（P〈0.05）.Conclusion：Hemodialysis combined with blood perfusion can significantly improve the chronic renal failure patients with calcium and phosphorus metabolism disorders,to ease the inflammation,effectively control renal function and improve the nutritional status which would be advantageous to the prognosis of patients.