血液透析滤过联合血液灌流治疗尿毒症的效果及对生化指标的影响

Effect of Hemodiafiltration Combined with Hemoperfusion in the Treatment of Uremia and Its Effect on Biochemical Indices

目的:探讨血液透析滤过联合血液灌流治疗尿毒症的效果及对生化指标的影响。方法:选择新疆生产建设兵团第二师焉耆医院2018年4月至2020年3月收治的尿毒症患者90例,根据随机数字表法分为联合组(45例)和对照组(45例)。对照组常规行血液透析滤过治疗,联合组在此基础上,加用血液灌流治疗,比较两组生化指标与透析相关不良症状发生率。结果:治疗4周后,联合组磷(P)、钙(Ca)、iPTH、骨钙素(BGP)、β2微球蛋白(β2-MG)水平较对照组低,差异有统计学意义(P<0.05);两组治疗4周后尿素氮(BUN)、肌酐(Cr)水平相比,差异无统计学意义(P>0.05);联合组骨关节炎、肌肉酸痛、皮肤瘙痒、肩周炎发生率较对照组低,差异有统计学意义(P<0.05)。结论:血液透析滤过联合血液灌流治疗利于清除尿毒症患者体内蓄积的iPTH、P、Ca等大分子物质,降低透析相关不良症状发生率。

Objective:To investigate the effect of hemodiafiltration combined with hemoperfusion on uremia and its effect on biochemical indexes.Methods:90 cases of uremic patients admitted from April 2018 to March 2020 in Yanqi Hospital,Second Division of Xinjiang Production and Construction Corps,According to the random number table method,it was divided into the combined group(45 cases)and the control group(45 cases).The control group was treated with hemodiafiltration,On that basis,The combined group was treated with hemoperfusion.The incidence of adverse symptoms related to dialysis was compared between the two groups.Results:After 4 weeks of treatment,the levels of phosphorus(P),calcium(Ca),iPTH,osteocalcin(BGP),2 microglobulin(β2-MG)in the combined group were lower than those in the control group,There was a statistical difference(P<0.05);levels of urea nitrogen(BUN)and creatinine(Cr)after 4 weeks of treatment in both groups,There was no statistical difference(P>>0.05);The incidence of osteoarthritis,muscle soreness,skin itching and periarthritis of shoulder in the combined group was lower than that in the control group,There was a statistical difference(P<0.05).Conclusion:Hemodialysis and hemoperfusion are beneficial to remove iPTH,P,Ca and other macromolecular substances accumulated in uremic patients,Reduce the incidence of dialysis related adverse symptoms.