研究不同血液净化方式对维持性血液透析患者肾性骨病相关因素的影响

To Study the Influence of Different Blood Purification Methods on the Related Factors of Renal Osteopathy in Maintenance Hemodialysis Patients

目的研究并分析不同血液净化方式对维持性血液透析患者肾性骨病相关因素的影响。方法选取240例本院于2018年10月至2019年11月收治的肾性骨病患者,将以上患者一般资料导入计算机并采用计算机随机分组的方式将其分为A组(80例,接受HD治疗)、B组(80例,接受HFHD治疗)、C组(80例,接受HDF治疗),对比三组患者治疗前后Ca、PTH、P、β_(2)-MG、钙磷乘积5项肾性骨病相关指标、炎性因子水平以及治疗后患者不良反应表现。结果治疗前三组患者肾性骨病相关指标差异不明显,无统计学意义(P>0.05);治疗后A、B、C组均存在明显差异,且A组治疗后表现明显弱于B、C组,对比三组患者不良反应可知,A组患者较B、C组的不良反应率更高,A组的炎性因子水平也高于B、C组,以上数据差异有统计学意义(P<0.05)。结论在以上三种方式中,HFHD、HDF对肾性骨病具有较好的透析效果,其能更好的清除维持性血透患者的PTH与β_(2)-MG,并纠正钙磷的紊乱,进而减少透析后不良反应的发生率。其中HFHD操作更为方便,可推荐给各大医院使用。

Objective To study and analyze the influence of different blood purification methods on the related factors of renal osteopathy in maintenance hemodialysis patients.Methods Two hundred and forty patients with renal osteopathy treated in our hospital from October 2018 to November 2019 were selected.The general data of the above patients were imported into the computer and randomly divided into group A(80 cases,receiving HD treatment),group B(80 cases,receiving HFHD treatment)and group C(80 cases,receiving HDF treatment).The Ca,PTH,P,β_(2)-MG,calcium phosphorus product,five related indexes of renal bone disease,the level of inflammatory factors and the performance of patients'adverse reactions after treatment.Results There was no significant difference in the related indexes of renal osteopathy among the three groups before treatment(P>0.05).After treatment,there were significant differences among groups A,B and C,and the performance of group A was significantly weaker than that of group B and C.By comparing the adverse reactions of the three groups,it can be seen that the adverse reaction rate of group A was higher than that of group B and C,and the level of inflammatory factors in group A was also higher than that of group B and C.The above data difference was statistically significant(P<0.05).Conclusion In the above three ways,HFHD and HDF have better dialysis effect on renal osteopathy,which can better clear PTH,β_(2)-MG,correct the disorder of calcium and phosphorus,and reduce the incidence of adverse reactions after dialysis.HFHD is more convenient to operate,which can be recommended to major hospitals.