腹膜透析与血液透析治疗终末期糖尿病肾病患者的临床效果及安全性

Clinical effect and safety of peritoneal dialysis and hemodialysis in the treatment of end-stage diabetic nephropathy

目的观察腹膜透析(PD)与血液透析(HD)治疗终末期糖尿病肾病患者的临床效果及安全性。方法将我院2018年1月至2020年1月收治的80例终末期糖尿病肾病患者按治疗方式分为HD组(40例,HD治疗)和PD组(40例,PD治疗)。比较两组的尿毒症毒素清除效果、微炎症情况、营养状态及并发症发生情况。结果治疗后,HD组的BUN、Scr水平及24 h尿量均低于PD组(P<0.05)。治疗后,PD组的CRP、IL-6、TNF-α水平均低于HD组(P<0.05)。治疗后,PD组的ALB、TP、Hb水平均高于HD组(P<0.05)。PD组的心功能不全发生率低于HD组(P<0.05)。结论HD和PD在终末期糖尿病肾病治疗中各有优势,HD可更有效清除尿毒症毒素,PD对微炎症情况及营养状态改善效果更佳,且安全性更佳,临床可按需选择。

Objective To observe the clinical effect and safety of peritoneal dialysis(PD)and hemodialysis(HD)in the treatment of end-stage diabetic nephropathy.Methods A total of 80 patients with end-stage diabetic nephropathy admitted in our hospital from January 2018 to January 2020 were divided into HD group(40 cases,HD treatment)and PD group(40 cases,PD treatment)according to treatment methods.The efficacy of uremia toxin removal,micro inflammation,nutritional status and complications were compared between the two groups.Results After treatment,BUN and Scr levels and 24 h urine volume in the HD group were lower than those in the PD group(P<0.05).After treatment,CRP,IL-6 and TNF-αlevels in the PD group were lower than those in the HD group(P<0.05).After treatment,ALB,TP and Hb levels in the PD group were higher than those in the HD group(P<0.05).The incidence of cardiac insufficiency in the PD group was lower than that in the HD group(P<0.05).Conclusion HD and PD have their own advantages in the treatment of end-stage diabetic nephropathy.HD can remove uremia toxin more effectively,while PD has better effect and safety in improving micro inflammation and nutritional status,which can be selected according to clinical needs.