不同的透析方案对中、大分子毒素清除与瘙痒症状的疗效研究

Study on the Effect of Different Dialysis Regimen on Medium Molecular and Macromolecular Toxin Clearance and Itching Symptoms

目的分析不同的透析方案实施后对其中、大分子毒素和瘙痒症状的临床效果。方法方便选取自2016年1月—2017年2月到该院进行透析的66例患者作为研究对象,以不同的血液透析方式将其随机分为3组,A组22例给予血液透析+血液灌流(HD+HP),B组22例给予血液透析联合血液滤过(HDF),C组22例给予普通的血液透析(HP),分析透析后3组毒素清除率和瘙痒症状的缓解情况。结果 A组、B组透析对轻中度的皮肤瘙痒有明显的缓解作用,A组对重度皮肤瘙痒有部分缓解,B组对重度皮肤瘙痒缓解疗效较差,C组患者对皮肤瘙痒的缓解较差,重度无效,其中A组缓解率为86.36%,B组为63.64%,C组为27.27%,疗效对比差异有统计学意义(P<0.05);而透析后,A组患者Hcy、PTH、β2-MG、血磷、CPR等反应指标明显低于B组和C组,组间数据对比差异有统计学意义(P<0.05)。结论 HD+HP透析方案对于清除中、大分子毒素具有较好的效果,同时可以显著缓解患者的皮肤瘙痒症状,对于重度皮肤瘙痒也具有明显的改善作用,因此HD+HP方案治疗效果明显。

Objective This paper tries to analyze the clinical effect of different dialysis regimen on medium molecular and macromolecular toxins and pruritus. Methods A total of 66 patients dialyzed in this hospital from January 2016 to February2017 were conveniently divided into three groups according to different hemodialysis methods. 22 patients in group A were given hemodialysis and hemoperfusion（HD ＋HP） treatment, 22 cases in group B received hemodialysis combined with hemofiltration（HDF）, and 22 cases in group C received normal hemodialysis（HP）. The levels of toxin clearance and pruritus symptoms of the three groups were analyzed. Results The dialysis could obviously relieve mild and moderate skin itching of group A and group B; partial remission of severe skin itching in group A, less effect on relieving severe skin itching in group B and the same to group C, without any effect on severe skin itching. The rate of remission was 86.36% in group A, 63.64% in group B and 27.27% in group C. The difference was significant（P〈0.05）. After dialysis, the levels of Hcy,PTH, β2-MG, blood phosphorus, CPR and other reaction indicators were significantly lower than the group B and group C,the difference between the data was significant（P〈0.05）. Conclusion HD＋HP dialysis regimen has a good effect on the medium molecular and macromolecular toxin, and can significantly alleviate the skin pruritus of the patients, and it can obviously improve the skin itching. Therefore, the effect of HD ＋ HP is obvious.