腹膜透析联合血液透析治疗对慢性肾功能衰竭患者肾功能、肾纤维化指标及并发症的影响

Effects of peritoneal dialysis combined with hemodialysis treatment on renal function,renal fibrosis indicators,and complications in patients with chronic renal failure

目的分析腹膜透析联合血液透析治疗对慢性肾功能衰竭患者肾功能、肾纤维化指标及并发症的影响。方法回顾性分析2018年4月至2019年4月陕西省核工业二一五医院收治的105例慢性肾功能衰竭患者的临床资料,根据治疗方法不同分为对照组(使用常规治疗+腹膜透析治疗)49例和研究组(腹膜透析+血液透析治疗)56例。治疗前与治疗后1周,比较两组患者的治疗效果、肾功能[血肌酐(Scr)、尿素氮(BUN)]、肾纤维化指标[结缔组织生长因子(CTGF)、骨形态发生蛋白-7(BMP-7)]、生活质量及并发症发生情况。结果治疗后,研究组患者的总有效率为94.64%,明显高于对照组的77.55%,差异有统计学意义(P<0.05);治疗前,两组患者的肾功能、肾纤维化指标比较差异均无统计学意义(P>0.05),治疗后两组患者的相关指标均有所改善,但研究组和对照组患者治疗后的Scr[(14.52±4.10)μmol/L vs(18.53±4.22)μmol/L]、BUN[(540.32±220.10)mmol/L vs(679.52±220.32)mmol/L]、CTGF[(14.20±3.47)mg/L vs(16.20±3.55)mg/L]水平比较,观察组明显低于对照组,BMP-7[(16.52±3.88)μg/L vs(14.56±3.68)μg/L]水平比较,观察组明显高于对照组,差异均有统计学意义(P<0.05);治疗后,研究组患者的各项生活质量评分明显高于对照组,差异均有统计学意义(P<0.05);研究组患者治疗后的并发症总发生率为7.14%,明显低于对照组的20.41%,差异有统计学意义(P<0.05)。结论腹膜透析联合血液透析治疗慢性肾衰竭的临床疗效优于单独治疗,并可改善患者肾功能及生活质量,延缓肾纤维化,安全性尚可。

Objective To analyze the effects of peritoneal dialysis combined with hemodialysis treatment on re-nal function,renal fibrosis indicators,and complications in patients with chronic renal failure.Methods The clinical da-ta of 105 patients with chronic renal failure admitted to the Shaanxi Nuclear Industry 215 Hospital from April 2018 to April 2019 were retrospectively analyzed.According to different treatment,they were divided into a control group(con-ventional treatment+peritoneal dialysis treatment,49 cases)and a study group(peritoneal dialysis+hemodialysis treatment,56 cases).The clinical effect,renal function(Scrum creatinine[Scr],Urea nitrogen[BUN]),renal fibrosis indicators(con-nective tissue growth factor[CTGF],Bone morphogenetic protein-7[BMP]),quality of life,and incidence of complica-tions of patients before treatment and 1 week after treatment were compared between the two groups.Results After treat-ment,the total effective rate of the study group was 94.64%,which was significantly higher than 77.55%of the control group(P<0.05).Before treatment,there were no statistically significant differences in renal function and renal fibrosis in-dexes between the two groups(P>0.05).After treatment,the relevant indicators of the two groups improved;Scr,BUN,and CTGF levels of the study group were significantly lower than those of the control group:Scr,(14.52±4.10)μmol/L vs(18.53±4.22)μmol/L;BUN,(540.32±220.10)mmol/L vs(679.52±220.32)mmol/L;CTGF,(14.20±3.47)mg/L vs(16.20±3.55)mg/L;the level of BMP-7 was significantly higher than that of the control group:(16.52±3.88)μg/L vs(14.56±3.68)μg/L;the differences were all statistically significant(P<0.05).After treatment,the quality of life score of the study group was significantly higher than that of the control group(P<0.05).The total incidence of complica-tions after treatment in the study group was 7.14%,significantly lower than 20.41%in the control group(P<0.05).Conclusion Peritoneal dialysis combined with hemodialysis has better clinical effect in the treatment of chronic re-nal failure than single treatment,which can improve the renal function and quality of life of patients,delay renal fibro-sis,with good safety.