对比终末期肾病应用常规血液透析和高通量血液透析的疗效

Comparison on the efficacy of conventional hemodialysis and high-flux hemodialysis in end-stage renal disease

目的 对比终末期肾病采取常规血液透析与高通量血液透析治疗的疗效。方法 92例终末期肾病患者,采取随机分组形式分为A组及B组,各46例。A组予以常规血液透析治疗, B组予以高通量血液透析治疗。对比两组患者透析前后的肾功能指标[血尿素氮(BUN)、血肌酐(Cr)]、心肌损伤标志物[心肌肌钙蛋白T(cTnT)、甲状旁腺激素(PTH)、B型脑钠肽(BNP)]水平及并发症发生率。结果 透析后, B组患者的BUN、Cr、cTnT、PTH、BNP水平分别为(11.16±4.12)mmol/L、(328.56±55.47)μmol/L、(14.77±6.59)ng/L、(518.55±68.79)ng/L、(0.48±0.16)μg/L,均低于A组的(14.52±4.50)mmol/L、(358.54±57.24)μmol/L、(30.33±8.62)ng/L、(844.62±95.24)ng/L、(0.81±0.26)μg/L,差异具有统计学意义(P<0.05)。两组患者低血压、肺部感染、营养失衡、肌痉挛以及心肌缺血发生率对比,差异均无统计学意义(P>0.05)。结论 在终末期肾病治疗中,采取高通量血液透析治疗对比常规血液透析能够更好的改善患者肾功能水平,且对患者心肌损伤小,安全性高,建议推广应用。

Objective To compare the efficacy of conventional hemodialysis and high-flux hemodialysis in end-stage renal disease.Methods A total of 92 patients with end-stage renal disease were randomly divided into group A and group B,with 46 cases in each group.Group A was treated with conventional hemodialysis,and group B was treated with high-flux hemodialysis.Both groups were compared in terms of renal function indexes[blood urea nitrogen(BUN),serum creatinine(Cr)],myocardial injury markers[cardiac troponin T(cTnT),parathyroid hormone(PTH),B-type natriuretic peptide(BNP)]levels before and after dialysis,and complication rates.Results After dialysis,the levels of BUN,Cr,cTnT,PTH,and BNP in group B were(11.16±4.12)mmol/L,(328.56±55.47)μmol/L,(14.77±6.59)ng/L,(518.55±68.79)ng/L,and(0.48±0.16)μg/L,which were lower than(14.52±4.50)mmol/L,(358.54±57.24)μmol/L,(30.33±8.62)ng/L,(844.62±95.24)ng/L,and(0.81±0.26)μg/L in group A,and the differences were all statistically significant(P<0.05).There was no statistically significant difference in the incidence of hypotension,pulmonary infection,nutritional imbalance,muscle spasm and myocardial ischemia between the two groups(P>0.05).Conclusion In the treatment of end-stage renal disease,high-flux hemodialysis can better improve the level of renal function of patients compared with conventional hemodialysis,with less myocardial injury and high safety.Therefore,it is recommended to be popularized and applied.