血液灌流治疗长期血液净化继发性甲状旁腺功能亢进患者的效果

Effects of hemoperfusion in patients with hyperparathyroidism secondary to long-term blood purification

目的:观察血液灌流治疗长期血液净化继发性甲状旁腺功能亢进(SHPT)患者的效果。方法:选取2019年1月到2021年1月该院收治的70例长期血液净化继发SHPT患者进行前瞻性研究,以随机数字表法分为观察组和对照组各35例。对照组采用血液透析治疗,观察组在对照组基础上采用血液灌流治疗,比较两组治疗前后生化指标[血钙、全段甲状旁腺激素(iPTH)、血肌酐(Scr)、钙磷乘积]水平、炎性因子[降钙素原(PCT)、β_(2)微球蛋白(β_(2)-MG)、C反应蛋白(CRP)]水平、氧化应激指标[超氧化物歧化酶(SOD)、还原型谷胱甘肽(GSH)、丙二醛(MDA)]水平和治疗期间并发症发生率。结果:治疗后,两组iPTH、Scr、钙磷乘积水平均低于治疗前,且观察组低于对照组,两组血钙水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);治疗后,观察组PCT、CRP、β_(2)-MG、MDA水平均低于对照组,SOD、GSH水平均高于对照组,差异有统计学意义(P<0.05);两组治疗期间并发症发生率比较,差异无统计学意义(P>0.05)。结论:在血液透析治疗基础上采用血液灌流治疗长期血液净化继发SHPT患者可改善生化指标和氧化应激指标水平,降低炎性因子水平,效果优于单纯血液透析治疗。

Objective:To observe effects of hemoperfusion in patients with hyperparathyroidism secondary(SHPT)to long-term blood purification.Methods:A prospective study was conducted on 70 patients with SHPT secondary to long-term blood purification who were admitted to this hospital from January 2019 to January 2021.They were divided into observation group and control group by using the random number table method,35 cases in each group.The control group was treated with hemodialysis,while the observation group was treated with hemoperfusion on the basis of that of the control group.The levels of biochemical indexes[serum calcium(Ca),intact parathyroid hormone(iPTH),serum creatinine(Scr),calcium-phosphorus product],the inflammatory factor levels[procalcitonin(PCT),β_(2) microglobulin(β_(2)-MG),C-reactive protein(CRP)],the oxidative stress indicator levels[superoxide dismutase(SOD),reduced glutathione(GSH),malondialdehyde(MDA)]levels and the incidence of complications during the treatment were compared between the two groups before and after the treatment.Results:After the treatment,the iPTH,Scr,calcium and phosphorus product levels in the two groups were lower than before the treatment,and those of the observation group were lower than those of the control group;the Ca levels in the two groups were higher than before the treatment,and that of the observation group was higher than that of the control group;and the differences were statistically significant(P<0.05).After the treatment,the levels of PCT,CRP,β_(2)-MG and MDA in the observation group were lower than those in the control group;the levels of SOD and GSH were higher than those in the control group;and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of complications between the two groups during the treatment(P>0.05).Conclusions:On the basis of hemodialysis treatment,the hemoperfusion therapy can improve the levels of biochemical indexes and the oxidative stress indicators,and reduce the levels of inflammatory factors in the patients with SHPT secondary to long-term blood purification.Moreover,it is superior to single hemodialysis treatment.