老年慢性肾衰竭患者不同血液净化方式对其营养状况及炎性反应的影响

Effects of different blood purification methods on nutritional status and inflammatory response in elderly patients with chronic renal failure

目的探讨老年慢性肾衰竭患者不同血液净化方式对其营养状况及炎性反应的影响。方法选取丽水市人民医院2020年1月至2022年1月收治的老年慢性肾衰竭患者120例,根据随机数字表法分为对照组和观察组,各60例。对照组给予单纯血液透析治疗,观察组在对照组基础上给予血液透析滤过治疗。比较两组治疗前后营养状况、炎性反应及肾功能相关指标的差异。结果观察组治疗后血清总蛋白、白蛋白、血红蛋白及血肌酐清除率均高于对照组[(65.61±4.82)g/L比(61.26±3.51)g/L、(36.54±4.52)g/L比(31.53±3.32)g/L、(97.58±5.84)g/L比(93.06±5.17)g/L、(41.88±4.87)ml/min比(34.51±4.36)ml/min],白细胞介素6、C反应蛋白、肿瘤坏死因子-α、血肌酐及尿素氮均低于对照组[(120.09±9.36)ng/L比(157.17±14.27)ng/L、(7.15±1.16)mg/L比(14.17±2.74)mg/L、(22.14±6.67)ng/L比(33.87±7.28)ng/L、(327.16±44.35)μmol/L比(378.59±48.27)、(10.15±2.03)mmol/L比(15.83±3.31)mmol/L],差异均有统计学意义(P<0.05)。结论对老年慢性肾衰竭患者采用杂合型血液净化方式,能够显著降低机体内毒素,改善患者营养状况以及炎性反应情况,值得临床推广。

Objective To investigate the effects of different blood purification methods on their nutritional status and inflammatory response in elderly patients with chronic renal failure.Methods A total of 120 elderly patients with chronic renal failure who were treated in Lishui People′s Hospital from January 2020 to January 2022 were selected as the research objects,and they were divided into the control group and the observation group according to the random number table method,with 60 cases in each group.The patients in the control group were given hemodialysis alone,and the patients in the observation group were given hemofiltration dialysis treatment on the basis of the patients in the control group.The nutritional status-related indicators,inflammation-related indicators and renal function-related indicators before and after treatment were compared between the two groups.Results After treatment,the levels of serum total protein(TP),albumin(ALB),hemoglobin(HGB)and creatinine clearance(Ccr)in the observation group were significantly higher than those in the control group:(65.61±4.82)g/L vs.(61.26±3.51)g/L,(36.54±4.52)g/L vs.(31.53±3.32)g/L,(97.58±5.84)g/L vs.(93.06±5.17)g/L,(41.88±4.87)ml/min vs.(34.51±4.36)ml/min,while the levels of interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),creatinine(Cr)and blood urea nitrogen(BUN)were significantly lower than those in control group:(120.09±9.36)ng/L vs.(157.17±14.27)ng/L,(7.15±1.16)mg/L vs.(14.17±2.74)mg/L,(22.14±6.67)ng/L vs.(33.87±7.28)ng/L,(327.16±44.35)μmol/L vs.(378.59±48.27),(10.15±2.03)mmol/L vs.(15.83±3.31)mmol/L,there were statistical differences(P<0.05).Conclusions For elderly patients with chronic renal failure,the use of hybrid blood purification can significantly reduce toxins in the body and improve the nutritional status and inflammation of patients,which is worthy of clinical promotion.