高通量血液透析治疗终末期肾病患者的效果

Effects of high-flux hemodialysis in patients with end-stage renal disease

目的:观察高通量血液透析(HFHD)治疗终末期肾病患者的效果。方法:选取2018年6月至2020年6月该中心收治的116例终末期肾病患者进行前瞻性研究,按照随机数字表法分为对照组(n=58)与观察组(n=58)。对照组采用低通量血液透析(LFHD)治疗,观察组采用HFHD治疗,比较两组治疗前后肾功能指标[血尿素氮(BUN)、血肌酐(Scr)、胱抑素C(Cys-C)]水平、血磷水平、血钙水平、营养状况[改良定量主观整体评估法(MQSGA)]评分、炎性因子[白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)]水平,以及并发症发生率。结果:治疗后,观察组BUN、Scr、Cys-C、血磷、IL-6、hs-CRP和TNF-α水平和MQSGA评分均低于对照组,血钙水平高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为6.90%(4/58),低于对照组的20.69%(12/58),差异有统计学意义(P<0.05)。结论:HFHD治疗终末期肾病患者可改善肾功能指标水平和营养状况,降低炎性因子水平、血磷水平和并发症发生率,提高血钙水平,效果优于LFHD治疗。

Objective:To observe effects of high-flux hemodialysis(HFHD)in patients with end-stage renal disease.Methods:A prospective study of 116 patients with end-stage renal disease admitted to this center from June 2018 to June 2020 was performed,and they were divided into control group(n=58)and observation group(n=58)according to the random number table method.The control group was treated with low-flux hemodialysis(LFHD),while the observation group was treated with HFHD.The levels of renal function indexes[blood urea nitrogen(BUN),serum creatinine(Scr),cystatin C(Cys-C)],the serum phosphorus level,the serum calcium level,the nutritional status[modified quantitative subjective global assessment](MQSGA)score,the inflammatory factor levels[interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)],and the incidence of complications were compared between the two groups before and after the treatment.Results:After the treatment,the levels of BUN,Scr,Cys-C,serum phosphorus,IL-6,hs-CRP and TNF-αand the MQSGA score of the observation group were lower than those of the control group;the blood calcium level was higher than that of the control group;and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 6.90%(4/58),which was lower than 20.69%(12/58)in the control group,and the difference was statistically significant(P<0.05).Conclusions:HFHD in the treatment of the patients with end-stage renal disease can reduce the renal function index levels,the inflammatory factor levels,the serum phosphorus levels,the MQSGA scores and the incidence of complications,and increase the serum calcium levels.Moreover,it is superior to LFHD treatment.