血液透析和腹膜透析治疗老年终末期肾病的临床研究

Comparison of Hemodialysis and Peritoneal Dialysis in the Treatment of Older Patients with End-stage Renal Disease

目的探讨血液透析和腹膜透析对老年终末期肾病患者血清游离铁状态及认知功能的影响。方法选取2018年3月~2018年9月哈尔滨医科大学附属第二医院肾内科收治的老年终末期肾病患者90例为研究对象,根据透析方法将其分为血液透析组(52例)和腹膜透析组(38例),比较两组治疗效果、铁状态及认知功能。结果治疗后两组患者血尿素氮、血肌酐水平均低于治疗前,且腹膜透析组低于血液透析组(P<0.05);治疗后两组患者血红蛋白、铁蛋白水平均降低,腹膜透析组降低幅度较小(P<0.05)。治疗后两组患者蒙特利尔认知评估量表(MoCA)评分均高于治疗前,且腹膜透析组高于血液透析组(P<0.05)。结论腹膜透析对老年终末期肾病患者铁状态影响较小,可有效提升患者认知功能,临床效果优于血液透析。

Objective To investigate the effects of hemodialysis and peritoneal dialysis on serum free iron status and cognitive function in older patients with end-stage renal disease.Methods 90 older patients with end-stage renal disease in the Second Affiliated Hospital of Harbin Medical University were enrolled from March 2018 to September 2018.According to dialysis methods,they were divided into hemodialysis group(52 cases)and peritoneal dialysis group(38 cases).The therapeutic effect,iron status and cognitive function in the two groups were compared.Results After treatment,the levels of blood urea nitrogen and creatinine in the two groups were lower than those before treatment,and were lower in peritoneal dialysis group than those in hemodialysis group(P<0.05).After treatment,the levels of hemoglobin and ferritin in the two groups were decreased than those before treatment,while the decrease in peritoneal dialysis group were less than those in hemodialysis group(P<0.05).After treatment,MoCA score in the two groups was higher than that before treatment,and was higher in peritoneal dialysis group than that in hemodialysis group(P<0.05).Conclusion Peritoneal dialysis has little effect on iron status in older patients with end-stage renal disease,which might effectively improve the cognitive function of patients.The clinical efficacy of peritoned dialysis is better than that of hemodialysis.