中心静脉半永久置管对维持性血液透析患者微炎症因子及肾性贫血的影响

Effect of semi-permanent double-lumen central venous catheter on micro-inflammatory state and renal anemia in maintenance hemodialysis patients

目的探讨中心静脉半永久置管对维持性血液透析患者微炎症因子水平及肾性贫血的影响。方法对维持性血液透析患者的临床资料进行回顾性分析,根据置入半永久中心静脉导管方法不同将血透患者分为撕脱鞘组和导丝组。以门诊健康体检者20例为健康组。记录导丝组及撕脱鞘组患者尿素下降率(URR)及尿素清除指数(Kt/V)、血常规、C反应蛋白、血清铁蛋白等指标,比较组间差异。结果经不同方法治疗后,两组患者治疗后URR及Kt/V水平差异无统计学意义。与健康组比较,进行血透患者体内C反应蛋白水平、血清铁蛋白水平均明显偏高(P<0.05)。维持性血液透析6月后,与撕脱鞘组比较,导丝组患者体内C反应蛋白水平明显偏低,血清铁蛋白水平下降,血红蛋白及红细胞比容水平下降趋势减低(P<0.05)。结论维持性血液透析患者处于微炎症及肾性贫血状态,且撕脱鞘组微炎症及肾性贫血状态更为严重。

Objective To observe the effect of semi-permanent double-lumen central venous catheter on micro-inflammatory state and renal anemia in maintenance hemodialysis patients. Methods Clinical data of patients undergoing maintenance hemodialysis was retrospectively ananlyzed. The patients were classified into gnidewire group and scabbard group.Twenty healthy people were selected as healthy volunteer group.The URR, Hct, blood routine, serum C-reactive protein and serum ferritin of the maintenance hemodialysi group and the normal control group were detected. Results The URR and Hct of the maintenance hemodialysis patients had no significant difference with those of the healthy volunteer group（P〉0.05） .The serum C-reactive protein of the maintenance hemodialysis patients were significantly higher than those of the healthy volunteer group.The serum ferritin of the maintenance hemodialysis patients were significantly higher than those of healthy volunteer group （P〈0.05）.After six months maintenance hemodialysis, the serum C-reactive protein, and the serum ferritinof gnidewire group were significantly lower than those of scabbard group ,while the hemoglobin and the haematocrit of gnidewire group were significantly declined lower than those of scabbard group （P〈0.05）. Conclusion Micro-inflammatory state and renal anemia exists in maintenance hemodialysis patients, and these phenomenon had much more serious state in scabbard group.