血液透析联合血液灌流对慢性肾病患者钙磷和脂质代谢的影响

Effects of Hemodialysis Combined with Hemoperfusion on Calcium, Phosphorus and Lipid Metabolism in Patients with Chronic Kidney Disease

目的:探讨血液透析(HD)联合血液灌流(HP)对慢性肾病(CKD)患者钙磷和脂质代谢的影响。方法:选择阳江市中医医院2020年12月—2022年1月收治的CKD患者75例,采用随机数表法分为对照组(37例)与观察组(38例),对照组接受HD治疗,观察组在对照组基础上联合HP治疗。比较两组治疗前后钙、磷、血脂指标[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、肾功能的变化。结果:治疗前,两组钙、磷水平比较,差异无统计学意义(P>0.05);治疗后,观察组钙水平高于对照组,磷水平低于对照组,差异有统计学意义(P<0.05)。治疗前,两组TC、TG、HDL-C、LDL-C水平比较,差异无统计学意义(P>0.05),治疗后,观察组TC、TG、LDL-C水平低于对照组,HDL-C水平高于对照组,差异有统计学意义(P<0.05)。治疗前,两组残肾功能比较,差异无统计学意义(P>0.05);治疗后,观察组残肾功能水平高于对照组,差异有统计学意义(P<0.05)。结论:HD联合HP治疗CKD与仅用HD治疗比较可有效降低血磷、血脂水平,稳定钙磷、脂质代谢,保护患者残肾功能。

Objective:To investigated the effect of hemodialysis(HD)combined with hemoperfusion(HP)on calcium,phosphorus and lipid metabolism in patients with chronic kidney disease(CKD).Method:A total of 75 CKD patients admitted to Yangjiang Traditional Chinese Medicine Hospital from December 2020 to January 2022 were selected,and they were divided into control group(37 cases)and observation group(38 cases)according to the method of random number table.The control group received HD treatment,and the observation group combined with HP treatment on the basis of the control group.The changes of calcium,phosphorus,lipids[total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)]and renal function before and after treatment were compared between the two groups.Result:Before treatment,there were no significant differences in calcium and phosphorus levels between the two groups(P>0.05).After treatment,the calcium level in the observation group was higher than that in the control group,and the phosphorus level was lower than that in the control group,the differences were statistically significant(P<0.05).There were no significant differences in the levels of TC,TG,HDL-C and LDL-C between the two groups before treatment(P>0.05).After treatment,the levels of TC,TG and LDL-C in the observation group were lower than those in the control group,and the level of HDL-C in the observation group was higher than that in the control group,the differences were statistically significant(P<0.05).Before treatment,there was no significant difference in residual kidney function between the two groups(P>0.05).After treatment,the level of residual renal function in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Compared with HD alone,HD combined with HP in the treatment of CKD can effectively reducing blood phosphorus and blood lipid levels,stabilizing calcium phosphorus and lipid metabolism,and protecting the residual renal function of patients.