糖尿病肾病尿毒症患者的血透治疗分析

Analysis of hemodialysis in uremic patients with diabetic nephropathy

目的分析糖尿病肾病尿毒症患者的血透治疗效果。方法选取2011年1月1日~2013年12月1日在本院接受血透治疗的糖尿病肾病尿毒症患者和非糖尿病肾病尿毒症患者作为研究对象,各50例,分别纳入A组和B组。比较两组治疗后的生化指标、血透充分性指标、并发症发生情况以及生存情况。结果在生化指标方面,A组肌酐水平(914.63±84.59)μmol/L、血浆白蛋白水平(31.26±4.59)g/L低于B组,血糖水平(9.58±2.15)mmol/L较B组更高(P<0.05),其他三项生化指标比较差异无统计学意义(P>0.05);在血透充分性指标方面,A组尿素清除指数(0.34±0.05)低于B组,单位时间平均尿素浓度(596.36±46.15)mg/L较B组更高(P<0.05),剩余两项指标差别较小(P>0.05);在并发症方面,两组高血压发生率比较接近(P>0.05),但其余并发症发生率均是A组更高(P<0.05);在生存率方面,A组两年和三年生存率均低于B组(P<0.05)。结论血透治疗糖尿病肾病尿毒症的疗效主要受并发症的影响,临床在治疗期间应积极预防并发症,同时采取其他有效措施使疗效提高。

Objective To analyze the hemodialysis effect of uremic patients with diabetic nephropathy. Methods 50 cases of diabetic nephropathy patients in our hospital from January lst,2011 to December lth,2013 were selected as group A,and 50 cases of non-diabetic nephropathy patients in our hospital from January lst,2011 to December lth,2013 were selected as group B.The biochemical indicators, hemodialysis adequacy index, complications and survival of the two groups were compared. Results In the biochemical indexes, the levels of creatinine（914.63 ± 84.59）μmol/L and plasma albumin （31.26 ±4.59）g/L were lower in group A than those in group B,and the blood sugar level （9.58 ± 2.15）mmol/L in group A was higher than that in group B（P 〈 0.05）.The other three biochemical indexes were not significantly different between the two groups（P 〉 0.05）.In the hemodialysis index,the urea clearance index （0.34 ± 0.05） in group A was lower than that in group B（P 〈 0.05）,the average urea concentration per unit time （596.36 ± 46.15）mg/L in group A was higher than that in group B（P 〈 0.05）,and the remaining two indicators were less significant（P 〉 0.05）.In the complication,the incidence of hypertension in the two groups was close（P 〉 0.05）,but the complication rate was higher in group A（P 〈 0.05）.In terms of survival rate,the two-year and three-year survival rates of group A were lower than those of group B（P 〈 0.05）. Conclusion The curative effect of hemodialysis on diabetic nephropathy is mainly affected by the complication.The clinical treatment should be reasonable to prevent the complication during the treatment,and take other effective measures to improve the curative effect.