高通量血液透析与血液滤过治疗对肾功能衰竭患者临床疗效的对比研究

Comparative study of clinical efficacy of high-flux hemodialysis and hemofiltration in patients with renal failure

目的比较高通量血液透析与血液滤过治疗对肾功能衰竭患者临床疗效的影响。方法采用回顾性研究方式,选取2015年1月至2018年8月首都医科大学附属北京世纪坛医院透析室收治的肾功能衰竭患者86例,根据不同血液净化方式分为A组和B组,每组各43例。A组患者采用高通量血液透析治疗,B组患者采用血液滤过治疗。比较两组患者的甲状旁腺激素(PTH)、血肌酐(Cr)、尿素氮(BUN)、血清磷(P3-)、血红蛋白(Hb)、血细胞比容(Hct)、白蛋白(Alb)、血清钾(K+)水平变化。结果治疗后,两组患者的Hb和Hct水平均比治疗前明显升高,且A组患者Hb和Hct水平均显著高于B组,差异均具有统计学意义(P <0.05);两组患者Alb水平均比治疗前明显降低,且A组患者的Alb水平明显低于B组,差异有统计学意义(P <0.05)。治疗前和治疗后两组患者的血钾水平比较,差异均无统计学意义(P>0.05);A组患者治疗后的Cr[(364.49±75.23) mmol/L]、BUN[(9.35±1.10) mmol/L]、P3-[(1.04±0.11)mmol/L]、PTH[(327.03±19.24) mmol/L]水平显著低于B组,两组比较差异具有统计学意义(P <0.05)。结论与血液滤过相比,高通量血液透析治疗可有效改善肾功能衰竭患者的肾脏功能,清除机体PTH,改善机体营养状况,疗效确切,值得推广。

Objective To compare the clinical efficacy of high-flux hemodialysis and hemofiltration in patients with renal failure.Methods A retrospective study was conducted to select 86 patients with renal failure admitted in Dialysis room of Beijing Shijitan Hospital,Capital Medical University from January 2015 to August 2018.The patients were divided into group A and group B according to different blood purification methods,with 43 cases in each group.Patients in group A were treated with high-flux hemodialysis,and patients in group B were treated with hemofiltration.The changes of PTH,Cr,BUN,P3-,Hb,Hct,Alb,K+levels in the two groups of patients were compared.Results After treatment,the levels of Hb and Alb in group A were significantly higher than those in group B,and the differences were statistically significant(P<0.05).The level of Hb in the two groups were significantly higher than before treatment,and the level of Alb were significantly decreased(P<0.05).There was no significant difference in blood potassium level between the two groups of patients before and after treatment (P>0.05).After treatment,the levels of Cr[(364.49±75.23) mmol/L],BUN[(9.35±1.10) mmol/L],P3-[(1.04±0.11) mmol/L],PTH[(327.03±19.24) mmol/L]levels in group A were significantly lower than those in group B,and the differences were statistically significant (P<0.05).Conclusion Compared with hemofiltration,high-flux hemodialysis treatment can effectively improve renal function in patients with renal failure,clear the body’s PTH,improve the body’s nutritional status.Its effect is definite,and it is worthy of promoting.