高通量血液透析治疗终末期肾病的效果及对透析充分性的影响

Effectiveness of High-flux Hemodialysis in the Treatment of End Stage Renal Disease and its Impact on DialysisAdequacy

目的:研究高通量血液透析在终末期肾病治疗中的应用效果及对透析充分性的影响。方法:选取2022年1—12月遂溪三鹤血液透析中心诊治的终末期肾病患者123例作为研究对象,采用随机数字表法分为研究组和对照组。对照组61例,采用常规血液透析;研究组62例,采用高通量血液透析。比较两组患者肾功能指标、炎性因子、营养指标、透析充分性及并发症发生情况。结果:治疗后,两组血尿酸、血肌酐、血尿素氮水平均降低,且研究组低于对照组,差异有统计学意义(P<0.05);治疗后,两组C反应蛋白、白细胞介素-6、肿瘤坏死因子-α水平均降低,且研究组低于对照组,差异有统计学意义(P<0.05);治疗后,两组总蛋白、前白蛋白、白蛋白、血红蛋白、血细胞比容均降低,且研究组高于对照组,差异有统计学意义(P<0.05);研究组尿素清除率、尿素氮下降率、β2微球蛋白清除率高于对照组,差异有统计学意义(P<0.001);研究组并发症发生率低于对照组,差异有统计学意义(P=0.035)。结论:在针对终末期肾病患者进行透析治疗时,选择高通量血液透析模式能够获得更为理想的治疗效果,建议在实际的透析治疗中予以借鉴。

Objective:To study the effect of the application of high-flux hemodialysis in the treatment of end stage renal disease and its impact on dialysis adequacy.Methods:One hundred and twenty-three patients with end stage renal disease diagnosed and treated in Suixi Sanhe Hemodialysis Center from January to December 2022 were selected as the study subjects,and were divided into a study group and a control group by using the random number table method.Sixty-one cases in the control group were treated with conventional hemodialysis,and sixty-two cases in the study group were treated with high-flux hemodialysis.Renal function indexes,inflammatory factors,nutritional indexes,dialysis adequacy and the occurrence of complications were compared between the two groups.Results:After treatment,the levels of blood uric acid,blood creatinine and blood urea nitrogen were reduced in both groups,and the study group was lower than the control group,with statistically significant differences(P<0.05);After treat⁃ment,the levels of C-reactive protein,interleukin-6,and tumor necrosis factor-αwere reduced in both groups,and the study group was lower than the control group,and the difference was statistically significant(P<0.05);After treatment,total protein,pre⁃albumin,albumin,hemoglobin,and erythrocyte specific volume were reduced in both groups,and the study group was higher than the control group,and the difference was statistically significant(P<0.05);The urea clearance rate,urea nitrogen decrease rate,andβ2-microglobulin clearance rate were higher in the study group than in the control group,and the difference was statistically significant(P<0.001);The complication rate of the study group was lower than that of the control group,and the difference was sta⁃tistically significant(P=0.035).Conclusion:When dialysis treatment is carried out for patients with end stage renal disease,the choice of high-flux hemodialysis mode can achieve more ideal therapeutic effects,and it is recommended that it should be taken into account in the actual dialysis treatment.