高通量血液透析对血透患者可溶性转铁蛋白受体的影响及肾性贫血的改善效果

Effect of high flux hemodialysis on renal anemia and soluble transferrin receptor in hemodialysis patients

目的:探讨高通量血液透析对血透患者可溶性转铁蛋白受体的影响及肾性贫血的改善效果。方法:选取2017年7月~2019年7月于本院行维持性血液透析患者132例,随机分为对照组和观察组各66例。观察组采用高通量血液透析,对照组采用低通量血液透析,各治疗6个月。比较两组治疗前后血清β2微球蛋白(β2-MG)、血肌酐(Scr)、血尿素氮(BUN)水平,贫血相关指标[红细胞压积(HCT)、血红蛋白(Hb)、网织红细胞百分比(Ret%)],铁代谢指标[血清铁蛋白(SF)、转铁蛋白饱和度(TSAT)、铁调素(Hepc)],可溶性转铁蛋白受体(sTfR)水平及不良反应情况。结果:治疗后,两组Scr、BUN水平均明显降低,差异具有统计学意义(P<0.05);观察组β2-MG水平低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组Hb、HCT水平均高于对照组,Ret%低于对照组,差异均具有统计学意义(P<0.05)。治疗后,观察组ST、TAST水平均高于对照组,sTfR、Hepc水平低于对照组,差异均具有统计学意义(P<0.05)。观察组不良反应总发生率低于对照组,差异无统计学意义(P>0.05)。结论:高通量血液透析可明显改善血透患者肾性贫血,降低血清sTfR水平,且不良反应少,安全性高。

Objective:To investigate the effect of high flux hemodialysis on soluble transferrin receptor in hemodialysis patients and the improvement of renal anemia.Methods:Totally 132 patients receiving maintenance hemodialysis in our hospital from July 2017 to July 2019 were selected and divided into control group and observation group according to the random number table method,with 66 cases each.The observation group was treated with high-flux hemodialysis,while the control group was treated with low-flux hemodialysis for 6 months.Indexes including serum beta 2 microglobulin(β2-MG),serum creatinine(Scr),blood urea nitrogen(BUN)level,anemia related index red blood cells deposited(HCT),hemoglobin(Hb),reticulocyte percentage(Ret%),iron metabolism index serum ferritin(SF),transferrin saturation(TSAT)、Hepcidin(Hepc),soluble transferrin receptor(sTfR)levels and adverse reactions in two groups before and after treatment were compared.Results:The levels ofβ2-MG,Scr and BUN in the two groups before treatment were compared(P>0.05).After treatment,Scr and BUN levels in the two groups were significantly decreased(P<0.05),but there is no significant difference between the two groups(P>0.05).The level ofβ2-MG in the observation group was lower than that in the control group(P<0.05).Before treatment,sTfR,Hb,HCT level and Ret%of the two groups were compared(P>0.05).After treatment,Hb and HCT levels in the observation group were higher than those in the control group,while Ret%were lower than those in the control group(P<0.05).Before treatment,the levels of ST,TAST,sTfR and Hepc in the two groups were compared(P>0.05).After treatment,the level of ST and TAST in the observation group was higher than that in the control group,The levels of sTfR and Hepc were lower than the control group(P<0.05).The overall incidence of adverse reactions in the observation group(8.93%)was lower than that in the control group(10.14%),with no significant difference(P>0.05).Conclusion:The high-flux hemodialysis significantly improved renal anemia in hemodialysis patients,reduced serum sTfR level,and had fewer adverse reactions and higher safety.