高通量血液透析对肾衰竭维持性血液透析患者并发症及炎症状态的影响研究

Effect of High-flux Hemodialysis on Complications and Inflammatory Status in Patients with Renal Failure Maintenance Hemodialysis

目的分析高通量血液透析对肾衰竭维持性血液透析患者并发症及炎症状态的影响。方法选取2017年8月-2018年8月在院内接受治疗的50例肾衰竭患者作为观察对象,以及血液透析方案的不同进行分组,其中25例常规血液透析患者为对照组,另外25例高通量血液透析患者为观察组,对比两种透析方案安全性。结果治疗前,两组患者Hb浓度差异无统计学意义(P>0.05),经不同方案血液透析治疗后,观察组患者治疗后1周~3周的Hb浓度均稍显著高于对照组,差异有统计学意义(t=7.425、7.516、7.495,P=0.041、0.042、0.041);经治疗后,观察组患者TNF-α为(69.25±2.14)pg/L、IL-6为(40.15±2.35)ng/L、Hs-CRP为(60.36±2.57)mmol/L,显著小于对照组的(84.62±2.36)pg/L、(61.25±2.48)ng/L、(75.16±5.29)mmol/L,差异有统计学意义(t=12.514、19.548、12.264,P=0.003、0.001、0.003);经不同血液透析方案治疗后,观察组患者的MQSGA评分显著小于对照组,BMI显著高于对照组,差异有统计学意义(t=7.526、8.625,P=0.041、0.024);观察组患者生理机能评分及生理职能评分等均处于85分之上,而对照组患者的生理机能评分及生理职能评分等均小于75分,两组患者生活质量相关指标评分差异有统计学意义(t=8.624、8.415、8.526、9.051、8.342、8.415、8.265,P=0.025、0.024、0.026、0.018、0.024、0.023、0.026)。结论维持性血液透析是维持肾衰竭患者生命的有效手段,实际应用中可选择不同方案,而与常规透析进行对比,高通量血液透析更有助于改善患者基体微炎症状态及营养状态,具有更高应用价值。

Objective To analyze the effect of high-flux hemodialysis on complications and inflammatory status in patients with renal failure maintenance hemodialysis. Methods Fifty patients from August 2017 to August 2018 with renal failure who were treated in the hospital were selected as subjects and different hemodialysis programs. 25 patients with routine hemodialysis were selected as the control group, and 25 patients with high-throughput hemodialysis as the observation group. Two groups of dialysis protocols were compared. Results Before treatment, there was no statistically significant difference in Hb concentration between the two groups(P>0.05). After different hemodialysis treatments, the Hb concentration in the observation group was significantly higher than that in the control group from 1 week to 3 weeks after treatment,the difference was not statistically significant(t= 7.425, 7.516, 7.495;P=0.041, 0.042, 0.041);after treatment, the TNF-α was(69.25±2.14)pg/L, IL-6 was(40.15±2.35)ng/L, and Hs-CRP was(60.36±2.57)mmol/L, significantly less than the control group of(84.62 ± 2.36)pg/L,(61.25 ± 2.48)ng/L,(75.16 ± 5.29)mmol/L,the difference was statistically significant(t=12.514, 19.548, 12.264;P=0.003, 0.001, 0.003);After treatment with hemodialysis protocol, the MQSGA score of the observation group was significantly lower than that of the control group, and the BMI was significantly higher than that of the control group,the difference was statistically significant(t=7.526, 8.625;P=0.041,0.024). The physiological function score and physiological function score of the observation group were at Above 85 points, the physiology scores and physiological function scores of the control group were less than 75 points. There were significant differences in the scores of quality of life related indicators between the two groups(t=8.624, 8.415, 8.526,9.051, 8.342, 8.415, 8.265;P =0.025, 0.024, 0.026,0.018, 0.024, 0.023, 0.026). Conclusion Maintenance hemodialysis is an effective means to maintain the life of patients with renal failure. In practice, different options can be selected. Compared with conventional dialysis, high-flux hemodialysis can improve the micro-inflammatory state and nutritional status of patients, with higher application value.