腹膜透析和血液透析治疗终末期糖尿病肾病的效果对比

Comparison of peritoneal dialysis and hemodialysis in the treatment of ESDN

目的研究探讨腹膜透析(PD)和血液透析(HD)治疗终末期糖尿病肾病(ESDN)的效果差异。方法选择我院肾内科收治的112例ESDN患者,根据透析方式分为两组,PD组43例,HD组69例。治疗12个月后,观察两组患者的各种检查指标间的差异(包括尿量、平均动脉压、血清白蛋白、血肌酐、血红蛋白、血磷、血钙、血钾、血糖及血脂等)及不良事件的发生情况(包括心律失常、高血压、心功能不全、感染、出血及死亡等)。结果在治疗12个月后,PD组患者的尿量明显多于HD组(P<0.05),PD组患者的平均动脉压和血清白蛋白值低于HD组(P<0.05),且两组患者透析后的平均动脉压、血肌酐及血红蛋白值均与透析前有较大的改变(P<0.05),但PD组患者透析前后的尿量及血清白蛋白值变化比较,差异无统计学意义(P>0.05),两组ESDN患者的血磷、血钙、血钾、血糖、血脂间的变化比较差异无统计学意义(P>0.05);治疗期间PD组患者的心率失常、高血压、心功能不全及出血发生率均低于HD组(P<0.05),但其感染发生率明显高于HD组(P<0.05),两组患者的死亡率差异无统计学意义(P>0.05)。结论 PD及HD均可有效治疗ESDN患者,在治疗效果上对比互有利弊,需根据患者的实际情况选择合适的治疗方案。

Objective To explore the effect difference of Peritoneal dialysis(PD)an d hemodialysis(HD)are used totreat end-stage diabetic nephropathy(ESDN).Methods112patients with ESDN cured in Department of Nephrologyof our hospital were selected and divided into two groups according to dialysis mode,with43cases in PD group and69cases in HD group.After12months of treatment,the differences among the indexes(urine volume,mean arterialpressure,serum albumin,blood creatinine,hemoglobin,serum phosphorus,serum calcium,blood potassium,blood sugarand blood lipids)and adverse events(including arrhythmias,hypertension,cardiac dysfunction,infection,bleeding,anddeath)of the two groups were compared.Results After12months of treatment,the urine volume of the PD groupwas significantly higher than that of the HD group(P<0.05),the mean arterial pressure and serum albumin valuesin the PD group were lower than those in the HD group(P<0.05),the mean arterial pressure,serum creatinine andhemoglobin values of the two groups were significantly different from those before dialysis(P<0.05),however,theurine volume and serum albumin value of patients in group PD before and after dialysis were not changed(P>0.05),andthere was no significant difference in blood phosphorus,serum calcium,blood potassium,blood sugar and blood lipidbetween the two groups(P>0.05).The difference between the two groups was statistically significant(ESDN).Theincidence of heart failure,hypertension,cardiac dysfunction and bleeding in PD group were lower than those in groupHD(P<0.05),however,the incidence of infection was significantly higher than that in group HD(P<0.05),andthere was no statistically significant difference in mortality between the two groups(P>0.05).Conclusion Both PDand HD can effectively treat ESDN patients,and there are advantages and disadvantages in the treatment effect.Theappropriate treatment options should be selected according to the actual situation of patients.