血液灌流联合血液透析治疗对尿毒症患者血清β2-MG、PTH水平及预后的影响

The effects of blood irrigation combined hemodialysis treatment on serum β2-MG, PTH level and prognosis in patients with uremia

目的探讨血液灌流联合血液透析治疗对尿毒症患者血清β2微球蛋白(β2-MG)、甲状旁腺素(PTH)水平及预后的影响。方法回顾性分析2014年5月-2016年5月于本院治疗尿毒症患者80例临床案例,按其治疗方式不同,将其分为试验组和对照组,各40例。对照组给予临床常规治疗及血液透析治疗,试验组在对照组基础上给予联合血液灌流治疗。统计分析两组患者治疗前后血清β2-MG、PTH水平、临床症状、治疗效果以及生活质量情况。结果治疗后4周、8周试验组患者血清β2-MG、PTH水平明显下降,而对照组无明显改善,试验组明显低于对照组,差异有统计学意义(P<0.05);两组患者治疗后临床症状均有所改善,而试验组临床症状睡眠障碍、食欲差、皮肤瘙痒及高血压发生率均明显低于对照组,差异有统计学意义(P<0.05);两组患者治疗效果显著,而试验组总有效率明显高于对照组,差异有统计学意义(P<0.05)。治疗后试验组组患者的各项生活质量评分均显著高于对照组,差异均有统计学意义(P<0.05)。结论血液灌流联合血液透析治疗尿毒症能有效清除患者体内β2-MG、PTH等中分子毒素,缓解患者临床症状,提高治疗效果,有利于改善患者生活质量。

Objective To investigate the effect of blood irrigation combined hemodialysis treatment on the levels of serum β2 microglobulin（β2-MG） and parathyroid hormone（PTH） level,and survival prognosis in patients with uremia.Methods 80 clinical cases of uremia were analyzed retrospectively from May 2014 to May 2016. According to their treatment methods,they were divided into experimental group and control group,each with 40 cases. The control group was given clinical routine treatment and hemodialysis treatment,and the experimental group was treated with combined blood irrigation on the basis of the control group. The serum β2-MG level,PTH level,clinical symptoms,therapeutic effect and quality of life of two groups of patients before and after treatment were analyzed. Results 4 weeks,8 weeks after treatment,the serum β2-MG and PTH levels in the experimental group were significantly lower than the control group（P〈0.05）. The clinical symptoms were improved in both groups after treatment. The symptoms of sleep disorders,poor appetite,skin itching,and incidence of hypertension of the experimental group were significantly improved when compared with the control group（P〈0.05）. The treatment effect was significant in both groups,while the total effective rate of the experimental group was significantly higher than that in the control group（P〈0.05）. The quality of life of the patients after treatment was significantly better than that of the control group（P〈0.05）. Conclusion Blood perfusion combined hemodialysis treatment in patients with uremia could effectively reduce the levels of β2-MG and PTH,relieve the clinical symptom,and improve patients′ quality of life.