高通量血液透析联合血液透析滤过序贯治疗慢性肾衰竭的临床效果及对钙磷代谢、预后的影响

Clinical effect of high-flux hemodialysis combined with hemodialysis filtration sequential therapy on chronic renal failure and its influences on calcium and phosphorus metabolism and prognosis

目的分析高通量血液透析(HFHD)联合血液透析滤过(HDF)序贯治疗慢性肾衰竭(CRF)的临床效果。方法选取2020年1月至12月我院接收的90例CRF患者为研究对象,随机将其分为常规组(45例,常规HFHD治疗)和联合组(45例,HFHD联合HDF序贯治疗)。比较两组的治疗效果。结果联合组的治疗总有效率高于常规组(P<0.05)。治疗后,联合组的血尿素氮(BUN)、血肌酐(Scr)、甲状旁腺素(PTH)及β2-微球蛋白(β2-MG)水平低于常规组,内生肌酐清除率(Ccr)显著高于常规组(P<0.05)。治疗后,联合组的钙(Ca)水平高于常规组,磷(P)、成纤维细胞生长因子-23(FGF-23)、镁(Mg)、降钙素(CT)及碱性磷酸酶(ALP)水平低于常规组,差异具有统计学意义(P<0.05)。治疗后,联合组的肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)及白细胞介素-8(IL-8)水平低于常规组,白细胞介素-10(IL-10)水平高于常规组,差异具有统计学意义(P<0.05)。联合组的不良反应总发生率低于常规组,差异具有统计学意义(P<0.05)。结论HFHD联合HDF序贯治疗CRF可取得理想的效果。

Objective To analyze the clinical effect of high-flux hemodialysis(HFHD)combined with hemodialysis filtration(HDF)sequential therapy on chronic renal failure(CRF).Methods A total of 90 CRF patients received in our hospital from January 2020 to December 2020 were selected as the research objects and randomly divided into conventional group(45 cases,routine HFHD therapy)and combined group(45 cases,HFHD combined with HDF sequential therapy).The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the combined group was higher than that in the conventional group(P<0.05).After treatment,the levels of blood urea nitrogen(BUN),serum creatinine(Scr),parathyroid hormone(PTH)andβ2-microglobulin(β2-MG)in the combined group were lower than those in the conventional group,and the endogenous creatinine clearance rate(Ccr)was significantly higher than that in the conventional group(P<0.05).After treatment,the level of calcium(Ca)in the combined group was higher than that in the conventional group,the levels of phosphorus(P),fibroblast growth factor-23(FGF-23),magnesium(Mg),calcitonin(CT)and alkaline phosphatase(ALP)were lower than those in the conventional group,and the differences were statistically significant(P<0.05).After treatment,the levels of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and interleukin-8(IL-8)in the combined group were lower than those in the conventional group,the level of interleukin-10(IL-10)was higher than that in the conventional group,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the combined group was lower than that in the conventional group,and the difference was statistically significant(P<0.05).Conclusion HFHD combined with HDF sequential therapy on CRF can achieve ideal effect.