腹膜透析、血液透析治疗终末期糖尿病肾病的效果分析

Efficacy and Safety of Peritoneal Dialysis and Hemodialysis in the Treatment of End-stage Diabetic Nephropathy

目的观察腹膜透析(peritoneal dialysis,PD)和血液透析(hemodialysis,HD)治疗终末期糖尿病肾病(end stage diabetic nephropathy,ESDN)的效果及安全性。方法选取我院2017年2月-2018年10月收治的ESDN患者113例,据透析治疗方法的不同分为PD组60例和HD组53例。比较透析1年后两组临床疗效,透析前及透析1年后两组血肌酐、尿素变化,透析前及透析1年后两组平均收缩压、平均舒张压及空腹血糖水平,透析前及透析1年后两组生活质量评价量表(short form 36 questionnaire,SF-36)评分,以及两组治疗期间不良事件发生情况。结果透析1年后,PD组治疗总有效率为85.00%高于HD组的67.92%(χ^2=4.632,P=0.031)。透析1年后血肌酐、尿素、平均收缩压、平均舒张压及空腹血糖较透析前降低,且PD组降低程度大于HD组,差异均有统计学意义(P<0.05或P<0.01)。透析1年后两组SF-36评分均较透析前升高,且PD组升高程度大于HD组,差异有统计学意义(P<0.05或P<0.01)。两组治疗期间总不良事件发生率比较差异无统计学意义(χ^2=0.027,P=0.869)。结论较HD,PD治疗ESDN的效果较好,可更好地控制患者血压及血糖水平,保护残余肾功能,提高患者生活质量。

Objective To compare the efficacy and safety of peritoneal dialysis(PD)and hemodialysis(HD)in the treatment of end stage diabetic nephropathy(ESDN).Methods A total of 113 ESDN patients admitted to our hospital from February 2017 to October 2018 were divided into PD group(n=60)and HD group(n=53).The clinical effect of the two groups at 1 year after dialysis was compared,and the changes of serum creatinine(Scr)and urea before and at 1 year after dialysis,the mean systolic blood pressure(SBP),mean diastolic blood pressure(DBP)and fasting blood glucose level before and at 1 year after dialysis,the short form 36 questionnaire(SF-36)before and at 1 year after dialysis,and the occurrence of adverse events during treatment in both groups were compared.Results At 1 year after dialysis,the total effective rate of PD group was 85.00%,which was higher than 67.92%of HD group(χ^2=4.632,P=0.031).At 1 year after dialysis,the Scr and urea,mean SBP,mean DBP and fasting blood glucose were lower than those before dialysis,and the decrease of PD group was greater than HD group(P<0.05 or P<0.01).At 1 year after dialysis,the SF-36 scores of the two groups were higher than those before dialysis,and the increase of PD group was greater than that of HD group(P<0.05 or P<0.01).There was no significant difference in the total rate of adverse events during treatment between two groups(χ^2=0.027,P=0.869).Conclusion Compared with HD,PD has a better effect on ESDN,which can better control blood pressure and blood glucose level,protect residual renal function and improve the quality of life of patients.