探讨PD、血液灌流及HD对终末期肾衰竭伴皮肤瘙痒患者钙磷代谢和PTH水平的影响

Investigate the Effects of PD,Hemoperfusion and HD on Calcium and Phosphorus Metabolism and PTH Level in Patients with End-Stage Renal Failure and Pruritus

目的:探讨终末期肾衰竭伴皮肤瘙痒患者应用腹膜透析(PD),血液灌流及血液透析(HD)对钙磷代谢和甲状旁腺激素(PTH)水平的影响。方法:本次研究对象共计102例,均筛选自2019年6月~2020年5月,所有患者均确诊为终末期肾衰竭伴皮肤瘙痒,利用数字表法分成3组,每组各34例,行PD治疗者为甲组、行血流灌注者为乙组、行HD治疗者为丙组,对比3组患者治疗前后钙磷代谢和PTH水平、瘙痒症状变化及不良反应情况。结果:(1)治疗前,3组患者PTH以及P、Ca水平没有较大差异,无统计学意义(P>0.05),治疗2个月后,甲组PTH、P、Ca水平最低,统计学意义成立(P<0.05);(2)治疗前,3组患者皮肤瘙痒症状评分相近,无统计学意义(P>0.05),治疗2个月后,甲组皮肤瘙痒症状评分最低,统计学意义成立(P<0.05);(3)3组患者不良反应发生率相近,差异无统计学意义(P>0.05)。结论:终末期肾衰竭伴随皮肤瘙痒患者应用PD治疗对钙磷代谢和PTH水平降低效果优于血液灌流和HD治疗,可更好缓解皮肤瘙痒症状,且安全性能理想,存在较大应用潜力。

Objective:Investigate the effects of PD,hemoperfusion and HD on calcium and phosphorus metabolism and PTH level in patients with end-stage renal failure and pruritus.Methods:102 patients with end-stage renal failure with pruritus were selected from June 2019 to May 2020,the number table method was divided into three groups,34 cases in each group,group A received peritoneal dialysis treatment,group B received blood perfusion,and group C received hemodialysis treatment,the calcium and phosphorus metabolism,PTH level,pruritus symptoms and adverse reactions were compared among the three groups before and after treatment.Results:①Before treatment,there was no significant difference in PTH,P and Ca levels among the three groups(P>0.05),after 2 months of treatment,PTH,P,Ca levels in group A were the lowest,the statistical significance was established(P<0.05);②Before treatment,the pruritus symptom score of the three groups were similar,without statistical significance(P>0.05),after 2 months of treatment,the pruritus symptom scores in group A was the lowest,the statistical significance was established(P<0.05);③The adverse reaction rates of the three groups were similar,there was no statistical significance in the difference(P>0.05).Conclusion:The effect of PD treatment on calcium and phosphorus metabolism and PTH level reduction in patients with end-stage renal failure accompanied by skin itching is better than that of hemoperfusion and HD treatment,which can better alleviate the symptoms of skin itching,with ideal safety performance,and has great application potential.