在线血液透析滤过对维持性血液透析患者生活质量影响的系统评价

Effect of online hemodiafiltration on quality of life of maintenance hemodialysis patients:a systematic review

目的系统评价在线血液透析滤过对维持性血液透析(maintenance Hemodialysis,MHD)患者生活质量的影响。方法计算机检索PubMed、Web of Science、Cochrane library、CNKI、VIP、万方数据库中在线血液透析滤过与血液透析对MHD患者生活质量影响的随机对照试验,检索时限为建库起至2019年8月30日。经筛选文献、提取资料、评价质量并交叉核对后,采用RevMan5.3软件进行Meta分析。结果纳入12篇随机对照试验,共1778例患者。Meta分析结果显示:在线血液透析滤过可改善MHD患者负性情绪[SMD=1.112,95%CI(0.081~2.142),P=0.040]和社会适应力[SMD=0.467,95%CI(0.032~0.886),P=0.042];而与血液透析相比,在线血液透析滤过对改善MHD患者的生理相关生活质量[SMD=-0.051,95%CI(-0.155~0.053),P=0.332]、心理相关生活质量[SMD=-0.041,95%CI(-0.141~0.076),P=0.483]和衰弱[SMD=0.352,95%CI(-0.469~1.163),P=0.403]方面无统计学差异。结论在线血液透析滤过可改善MHD患者负性情绪与社会适应力,但其对MHD患者的生理和心理相关生活质量及衰弱程度无显著影响。

Objective To systematically evaluate the effect of online hemodiafiltration(OL-HDF)on quality of life of maintenance hemodialysis(MHD)patients.Methods We used computer to search for the random and control studies about the effect of OL-HDF on quality of life of MHD patients during the period from the establishment of the databases to Aug.30,2019 in PubMed,Web of Science,Cochrane library,CNKI,VIP and Wan fang databases.Literature screening,data extraction,and the bias assessment of all eligible studies were independently conducted.RevMan 5.3 software was used for meta analyses.Results A total of 12 random and controlled trials involving 17,728 patients were included.The results showed thatOL-HDFcould improve the negative emotions(SMD=1.112,95%CI 0.081~2.142,P=0.040)and social activity(SMD=0.467,95%CI 0.032~0.886,P=0.042)in MHD patients.OL-HDF showed no significant differences in physiologyrelated quality of life(SMD=-0.051,95%CI-0.155~0.053,P=0.332),psychology-related quality of life(SMD=-0.041,95%CI-0.141~0.076,P=0.483)and fatigue(SMD=0.352,95%CI-0.469~1.163,P=0.403),as compared those in patients with conventional hemodialysis.Conclusions OL-HDF has better effects on improving negative emotion and social activities in MHD patients.However,there are no significant differences in physiology and psychology-related quality of life and fatigue between patients with OL-HDF and conventional hemodialysis.