腹膜透析治疗慢性肾功能衰竭患者的疗效及其对血清BUN、SCr、细胞因子水平的影响

Effect of peritoneal dialysis on serum BUN,SCr and cytokine levels in chronic renal failure

目的观察腹膜透析治疗慢性肾衰竭患者的疗效其及对肾功能、细胞因子水平的影响。方法选择2013年5月—2016年5月广东省农垦中心医院肾内科接受治疗的慢性肾功能衰竭患者150例作为研究对象,随机数字表法分成2组各75例。观察组患者应用腹膜透析治疗,对照组患者应用血液透析治疗。比较2组患者治疗前后肾功能、生化指标、细胞因子的变化及生存率、并发症发生率。结果 2组患者的肾功能指标(BUN、SCr、24 h UP)均较治疗前显著降低,但组间比较差异无统计学意义(t=0.622、0.247、1.438,P=0.267、0.402、0.076);2组生化指标(Alb、Hb及RBC)均较治疗前显著改善,并且观察组患者改善的更为显著(t=6.037、5.087、3.163,P=0.000、0.000、0.001);2组患者的细胞因子(CRP、TNF-α及IL-6)均较治疗前显著降低,但组间比较差异无统计学意义(t=0.683、1.256、0.567,P=0.248、0.106、0.286);2组患者在6个月及1年生存率方面比较差异无统计学意义(χ~2=0.362、0.432,P=0.547、0.511);观察组患者的心脑血管疾病发生率明显低于对照组,组间比较差异具有统计学意义(χ~2=13.453,P=0.000)。结论腹膜透析应用于慢性肾功能衰竭治疗能够获得与血液透析相近的临床效果,显著改善患者的肾功能、生化指标,降低细胞因子水平。

Objective To analyze and investigate the effect of peritoneal dialysis on BUN,SCr and cytokine levels in chronic renal failure.Methods One hundred and fifty cases of patients with chronic renal failure were selected,which were treated in hospital from May 2013 to May 2016, and they were divided into observation group（75 cases）and control group （75 cases）.The patients of observation group were treated with peritoneal dialysis, while the patients of control group were treated with hemodialysis.The survival rate,complication rate and changes of renal function,biochemical markers and cyto-kines levels of two groups were compared.Results After the appropriate treatment, the renal function index（BUN, SCr, 24 hUP）of the two groups were all significantly decreased than before,but the difference between groups was not statistically significant（t=0.622,t=0.247,t=1.438, P=0.267, P=0.402, P=0.076）; Biochemical indicators（Alb, Hb and RBC）levels of the two groups were all significantly improved than before,and the patients of the observation group got more significant improvement（t=6.037,t=5.087,t=3.163,P=0.000,P=0.000,P=0.001）;Cytokines（CRP, TNF-α and IL-6）levels of the two groups were all significantly decreased than before,but the difference between groups was not sta-tistically significant（t=0.683,t=1.256,t=0.567,P=0.248,P=0.106,P=0.286）;There was no statistically sig-nificant difference in survival rate between the two groups（χ2=0.362, χ2=0.432, P=0.547, P=0.511）; The inci-dence of cardiovascular and cerebrovascular diseases in the observation group was significantly lower than that in the control group（χ2=13.453,P=0.000）.Conclusion Peritoneal dialysis in treating patients with chronic renal failure can achieve similar clinical results with hemodialysis,significantly improve the patient＆#39;s renal function,biochemical indicators,reduce the levels of cytokines,which makes it worthy of popularization and application.