血液净化方式对维持性血液透析病人血清β2微球蛋白、瘦素清除率的影响分析

Effect analysis of blood purification methods on serum β2 microglobulin and leptin clearance rate in maintenance hemodialysis patients

目的研究不同血液净化方式对维持性血液透析病人血清β2微球蛋白(β2-MG)、瘦素清除率的影响。方法选取2011年1月至2016年1月平乡县人民医院血液净化中心收治的维持性血液透析病人120例为研究对象,以随机数字表法分为研究组与对照组,每组60例。对照组病人予以普通血液透析治疗,研究组病人则在对照组的基础上加用血液灌流治疗。对所有病人进行为期6个月的随访,分别对比治疗前后两组血清β2-MG、瘦素、甲状旁腺素(PTH)水平、心功能变化情况、并发症发生情况以及生活质量。结果治疗后研究组病人的血清β2-MG、瘦素、PTH水平分别为(17.4±3.9) mg/L、(17.8±4.1) mg/L、(80.1±22.5) ng/L,均显著低于对照组的(39.2±9.1) mg/L、(32.0±7.2) mg/L、(112.5±33.4) ng/L,均差异有统计学意义(均P<0.05)。治疗后研究组病人左室后壁厚度(LVPWT)、室间隔厚度(IVST)以及左室质量指数(LVMI)水平均显著低于对照组,均差异有统计学意义(均P<0.05)。研究组病人并发症发生率为5.00%(3/60),显著低于对照组的18.33%(11/60),差异有统计学意义(P<0.05)。治疗后研究组病人的各项生活质量评分均显著高于对照组,均差异有统计学意义(均P<0.05)。结论普通血液透析联合血液灌流对维持性血液透析病人的β2-MG、瘦素、PTH清除较单纯采用普通血液透析效果显著,有利于改善病人心功能,降低并发症发生率,提高病人生活质量。

Objective To study the effects of different blood purification methods on serum β2 microglobulin(β2-MG) and leptin clearance in maintenance hemodialysis patients.Methods A total of 120 cases of maintenance hemodialysis patients admitted to the blood purification center of Pingxiang County People’s Hospital from January 2011 to January 2016 were selected as the study subjects.They divided into study group and control group by random number table method,60 cases in each group.Patients in the control group were treated with ordinary hemodialysis,and patients in the study group were treated with blood perfusion on the basis of the control group.All patients were followed up for 6 months.The levels of serum β2-MG,leptin,parathyroid hormone(PTH),changes situation of cardiac function,complications occurrence,and quality of life between two groups were compared before and after treatment.Results After treatment,the serum levels of β2-MG,leptin and PTH in the study group were(17.4±3.9) mg/L,(17.8±4.1) mg/L,and(80.1±22.5) ng/L,respectively,which were significantly lower than the control group,(39.2±9.1) mg/L,(32.0±7.2) mg/L,(112.5±33.4) ng/L.The difference was statistically significant(P<0.05).After treatment,the left ventricular posterior wall thickness(LVPWT),interventricular septum thickness(IVST) and left ventricular mass index(LVMI) levels of patients in the study group were significantly lower than those in the control group(P<0.05).The complication rate of patients in the study group was 5.00%(3/60),which was significantly lower than that of the control group(18.33%(11/60).The difference was statistically significant(P<0.05).After treatment,the quality of life scores of the patients in the study group were significantly higher than the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with conventional hemodialysis,the ordinary hemodialysis combined blood perfusion has more significant effect on the recovery of β2-MG,leptin and PTH clear in maintenance hemodialysis patients,which is beneficial to improve the heart function,reduce the incidence of complications and improve the quality of life of patients.