高通量透析对尿毒症患者体内毒素清除效果及生活质量的影响

Effect of high flux dialysis on the effect of vivotoxin clearance and quality of life in patients with uremia

目的探讨高通量透析对尿毒症患者体内毒素清除效果及生活质量的影响。方法选择2015年1月~2017年1月于我院治疗的100例尿毒症患者为观察对象,按数字随机法均分为观察组和对照组各50例,观察组患者采用高通量透析,对照组采用常规血液透析,比较两组体内毒素清除效果、血清炎性因子水平、生活质量以及皮肤瘙痒评分。结果透析后两组患者血尿素、血钾、血肌酐、血尿酸比较,差异无统计学意义(P>0.05);观察组半胱氨酸蛋白酶抑制剂C、血磷、甲状旁腺激素、血β2微球蛋白水平显著低于对照组,差异有统计学意义(P<0.05);两组透析后血清CRP、IL-6水平均显著低于透析前,且观察组显著低于对照组,差异均有统计学意义(P<0.05);透析后健康调查量表(SF-36)中观察组除社会功能、躯体疼痛、情感职能外其他项目均显著高于对照组,差异均有统计学意义(P<0.05);观察组皮肤瘙痒程度、范围以及对睡眠影响评分均显著低于对照组,差异均有统计学意义(P<0.05)。结论高通量透析对半胱氨酸蛋白酶抑制剂C、甲状旁腺激素等中、大分子毒素的清除效果更佳,可改善机体炎症水平及瘙痒症状,提升患者生活质量。

Objective To investigate effect of high flux dialysis on the effect of vivotoxin clearance and quality of life in patients with uremia.Methods In this study,100 patients with uremia treated in our hospital from January 2015 to January 2017 were selected and randomly divided into observation group and control group.Patients in the observation group were given high-flux dialysis,while those in the control group were given conventional hemodialysis.Toxin clearance,serum inflammatory factors,quality of life and skin pruritus scores were compared between the two groups.Results There were no significant difference in blood urea,serum potassium,serum creatinine and serum uric acid between the two groups after dialysis(P>0.05).The levels of cystatin C,serum phosphorus,parathyroid hormone andβ2 microglobulin of the observation group were significantly lower than those of the control group(P<0.05).Serum levels of CRP and IL-6 of the two groups were significantly decreased after dialysis,and the levels of the observation group were significantly lower than that of the control group(P<0.05).In the SF-36 scale,items scores except for social function,somatic pain,and emotional functions in the observation group were significantly higher than those in the control group(P<0.05).The degree of skin pruritus,the extent and the impact on sleep in the observation group were significantly lower than the control group,the difference was statistically significant(P<0.05).Conclusion High flux dialysis has a better clearance effect on cysteine proteinase inhibitor C,parathyroid hormone and other large and medium molecular toxins,which can ameliorate the level of inflammation and itching symptoms,and improve the quality of life.