延长血液透析时间对伴有高磷血症的尿毒症患者血磷水平及生活质量的影响

Effects of Prolonged Hemodialysis on Serum Phosphorus Levels and Quality of Life in Uremia Patients with Hyperphosphatemia

目的:探究延长血液透析时间对伴有高磷血症的尿毒症患者血磷水平及生活质量的影响。方法:选取我院血液净化中心2020年1月—2021年9月收治的40例尿毒症伴高磷血症患者作为研究对象,采用分层、不设盲的随机对照研究方法进行分组,对照组(n=20例)采用维持性4h血液透析,实验组(n=20例)采用维持性5、6、7、8h延长血液透析,对比不同血液透析时间的差异性。结果:治疗前,两组血钙、血磷、PTH、IL-6、hs-CRP水平和KDQOL-SFTM1.3评分对比差异均无统计学意义(P>0.05);治疗后,两组血钙水平较治疗前无明显变化(P>0.05),两组血磷、PTH、IL-6和hs-CRP水平较治疗前均有所降低,KDQOL-SFTM1.3评分较治疗前均有所升高,且观察组变化幅度大于对照组(P<0.05);观察组不良反应发生率低于对照组(P<0.05)。结论:伴有高磷血症的尿毒症患者延长血液透析时间可更好地降低血磷水平,清除炎症细胞因子,改善生活质量,且不良反应较少,值得临床加以应用。

Objective:To investigate the effect of prolonging hemodialysis time on blood phosphorus level and quality of life of uremia patients with hyperphosphatemia.Methods:Forty patients with uremia and hyperphosphatemia admitted to the Blood Purification Center of our hospital from January 2020 to September 2021 were selected as the research objects,and divided into groups using stratified,non-blind randomized controlled study method.The control group(n=20 cases)received maintenance 4h hemodialysis.In the experimental group(n=20 cases),hemodialysis was prolonged for 5,6,7 and 8h,and the difference of different hemodialysis time was compared.Results:Before treatment,there were no significant differences in serum calcium,phosphorus,PTH,IL-6,hs-CRP levels and KDQOL-SFTM1.3 score between 2 groups(P>0.05).After treatment,serum calcium levels in 2 groups had no significant change compared with before treatment(P>0.05),serum phosphorus,PTH,IL-6 and hs-CRP levels in 2 groups were decreased compared with before treatment,KDQOL-SFTM1.3 score was increased compared with before treatment,and the range of change in observation group was greater than that in control group(P<0.05).The incidence of ADR in observation group was lower than that in control group(P<0.05).Conclusion:Prolonged hemodialysis in uremia patients with hyperphosphatemia can better reduce the blood phosphorus level,remove inflammatory cytokines,improve the quality of life,and have fewer adverse reactions,which is worthy of clinical application.