血液透析和腹膜透析对终末期糖尿病肾病的疗效对比

Comparison of effect of hemodialysis and peritoneal dialysis on end-stage diabetic nephropathy

目的对比血液透析和腹膜透析对终末期糖尿病肾病的疗效。方法选取2013年6月至2016年6月于郑州大学第一附属医院开始稳定透析的终末期糖尿病肾病患者,共收集98例,其中血液透析(HD)组患者55例,腹膜透析(PD)组患者43例,两组患者年龄和性别差异无统计学意义(P>0.05),收集所有患者初次透析时及透析1年后的资料。结果初次透析时收缩压、舒张压、尿量、体重、血糖、血钙、血磷、血钾、胆固醇(TCHO)、甘油三酯(TG)、白蛋白(ALB)、血红蛋白(HB)、尿素氮(BUN)和肌酐(Scr)水平两组之间均无统计学差异(P>0.05)。透析1年后,舒张压、体重、血糖、血钙、血磷、血钾、胆固醇(T-CHO)、甘油三酯(TG)和血红蛋白(HB)两组之间均无统计学差异(P>0.05);PD组收缩压水平、白蛋白(ALB)水平低于HD组(P<0.05),而尿量、尿素氮(BUN)和肌酐(Scr)水平均高于HD组(P<0.05)。尿素清除指数(Kt/V)HD组透析前后无差异(P>0.05),而PD组透析1年后较初次透析时下降(P<0.05)。PD组患者SF-36评分和KDTA评分均明显高于HD组(P<0.05)。结论血液透析和腹膜透析均是终末期糖尿病肾病患者的有效治疗方法,各有优劣。选择透析方案时应根据患者个人具体病情。

Objective To compare the effect of hemodialysis and peritoneal dialysis on end-stage diabetic nephropathy.Methods A total of 98 patients with end-stage diabetic nephropathy who underwent stable dialysis from June 2013 to June 2016 in our hospital were enrolled in this study,including hemodialysis group with 55 cases and peritoneal dialysis group with 43 cases. There was no significant differences between the two groups in age and gender(P〉0. 05）. The data of all patients were collected before and 1 year after dialysis. Results There was no significant differences between the two groups in systolic blood pressure,diastolic blood pressure,urine volume,weight,blood glucose,calcium,phosphorus,potassium,cholesterol(T-CHO）,triglyceride(TG）,albumin(ALB）,hemoglobin(HB）,urea nitrogen(BUN） and creatinine(Scr） before dialysis(P〉0. 05）. One year after dialysis,The difference between the two groups in diastolic blood pressure,blood glucose,calcium,phosphorus,potassium,cholesterol(T-CHO）,triglyceride(TG）and hemoglobin(HB） had no statistical significance(P〉0. 05）,while the level of systolic blood pressure and albumin(ALB） in PD group were lower than in HD group(P〈0. 05） and the level of urine volume,blood urea nitrogen(BUN） and creatinine(Scr） in PD group were higher than in HD group(P〈0. 05）. The scores of SF-36 and KDTA in PD group were significantly higher than those in HD group(P〈0. 05）. Conclusion Both hemodialysis and peritoneal dialysis are effective treatment for patients with end-stage diabetic nephropathy and both have advantages and disadvantages. Dialysis schemes should be chose according to concrete condition.