腹膜透析与血液透析治疗终末期糖尿病肾病的效果比较

Effect comparison of peritoneal dialysis and hemodialysis in the treatment of end-stage diabetic nephropathy

目的比较腹膜透析(PD)和血液透析(HD)治疗终末期糖尿病肾病患者的效果。方法回顾性分析2011年1月~2017年12月在我院接受治疗的75例终末期糖尿病肾病患者的临床资料,根据透析方法的不同分为PD组(38例)和HD组(37例)。比较两组患者治疗1年后的临床效果、血脂变化和不良反应发生情况。结果两组患者治疗后的血肌酐(SCr)、尿素氮(BUN)、24 h尿量、肾小球滤过率(GFR)均低于治疗前,差异有统计学意义(P<0.05);PD组治疗后的24 h尿量高于对照组,差异有统计学意义(P<0.05);PD组治疗后的三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)高于治疗前与对照组,差异有统计学意义(P<0.05);两组治疗前后的总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)比较,差异无统计学意义(P>0.05);两组患者的各不良反应发生率比较,差异均无统计学意义(P>0.05)。结论 PD和HD对糖尿病肾病尿毒症患者均具有可行性及有效性,但对24 h尿量、血脂的影响不同,需要根据患者的具体情况来决定透析方式。

Objective To compare the effect of peritoneal dialysis(PD) and hemodialysis(HD) in the treatment of endstage diabetic nephropathy. Methods A retrospective analysis was conducted in 75 patients with end-stage diabetic nephropathy who were treated in our hospital from January 2011 to December 2017. According to the different dialysis methods, they were divided into PD group and HD group, including 38 patients in PD group and 37 patients in HD group. The clinical efficacy, blood lipid changes and adverse reactions of the two groups of patients after 1 year of treatment were compared. Results The serum creatinine(SCr), urea nitrogen(BUN), 24 h urine volume, and glomerular filtration rate(GFR) of the two groups were lower than those before treatment(P<0.05). The urine volume of 24 h in the PD group was higher than that of the control group, and the difference was statistically significant(P<0.05). The levels of triglyceride(TG) and low-density lipoprotein cholesterol(LDL-C) in the PD group were significantly higher than those before treatment and the control group(P<0.05). There were no significant differences in total cholesterol(TC)and high-density lipoprotein cholesterol(HDL-C) between the two groups before and after treatment(P>0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion PD and HD are feasible and effective for patients with diabetic nephropathy and uremia, but have different effects on 24-hour urine volume and blood lipids. The dialysis method needs to be determined according to the specific conditions of the patients.