血液透析联合血液灌流治疗尿毒症皮肤瘙痒症的疗效

Hemodialysis Combined with Hemoperfusion in the Treatment of Uremia and Skin Pruritus

目的观察尿毒症皮肤瘙痒症(UP)患者在血液透析(HD)联合血液灌流(HP)治疗的疗果。方法选取2016年6月~2017年6月雅安市第二人民医院血液透析中心诊断为UP患者40例,行HD联合HP治疗,共6个月。比较患者治疗前后四项目瘙痒(Four-item Itch Questionnaire,FIIQ)量表评分、血白细胞(WBC)、全血红细胞(Hb)、血清肌酐(Cr)、血清尿素氮(Bun)、胱抑素C(Cys-C)、血清磷(P)、β2-微球蛋白(β2-MG)、甲状旁腺素(PTH)、C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平。结果HD联合HP治疗6个月后,36例(4例排除)患者WBC、Hb水平与治疗前比较,差异无统计学意义(P>0.05);治疗后FIIQ量表评分、Cr、BUN、Cys-C、P、β2-MG、PTH、CRP、IL-6、TNF-α较治疗前降低,差异有统计学意义(P<0.05)。结论HD联合HP有助于更好的清除UP患者体内的中小分子物质、调节水、电解质平衡,缓解UP患者的症状,值得借鉴。

Objective To observe the therapeutic effect of uremia and skin pruritus(UP)patients treated with hemodialysis(HD)combined with hemoperfusion(HP).Methods A total of 40 patients diagnosed as UP from the hemodialysis center of Ya'an Second People's Hospital from June 2016 to June 2017 were selected and treated with HD and HP for 6 months.Compare Four-item Itch Questionnaire(FIIQ)scale scores,white blood cells(WBC),whole blood red cells(Hb),serum creatinine(Cr),serum urea nitrogen(Bun),and cystatin C before and after treatment(Cys-C),serum phosphorus(P),β2-microglobulin(β2-MG),parathyroid hormone(PTH),C-reactive protein(CRP),interleukin 6(IL-6),tumor necrosis Factorα(TNF-α)levels.Results After 6 months of HD combined with HP,the levels of WBC and Hb in 36(4 excluded)patients were not significantly different from those before treatment(P>0.05);FIIQ scale scores,Cr,BUN,Cys-C,P,β2-MG,PTH,CRP,IL-6,TNF-αwere lower than before treatment,the difference was statistically significant(P<0.05).Conclusion HD combined with HP is helpful for better clearing of small and medium molecular substances,regulating water and electrolyte balance in patients with UP,and alleviating symptoms in patients with UP,which is worth learning.