血液灌注联合血液透析治疗慢性肾衰竭尿毒症期患者疗效观察

Effect of blood perfusion combined with hemodialysis in treatment of uremia patients with chronic renal failure

目的探究血液灌注联合血液透析对慢性肾衰竭/尿毒症期患者脂质代谢、炎症状态、肾纤维化指标及骨代谢的影响,为临床治疗该种病症提供借鉴。方法回顾性分析2021年12月—2022年12月来焦作市第二人民医院就诊的130例慢性肾衰竭/尿毒症期患者资料,根据治疗方法分为对照组(71例)、研究组(59例),其中对照组采用单纯血液透析,研究组采用血液灌注联合血液透析治疗。比较两组患者治疗前与治疗后6个月的脂质代谢情况、炎症情况、肾纤维化情况、骨代谢情况。结果结果显示,研究组的血清总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、和骨形态发生蛋白(bone morphogenetic protein,BMP)、C反应蛋白(C reactive protein,CRP)、肿瘤坏死因子-ɑ(tumor necrosis factor-ɑ,TNF-ɑ)、Ⅳ型胶原(collage typeVI,VI-Col)、层粘连蛋白(laminin,LN)、Ⅲ型前胶原N端肽(classⅢprocollagen N peptide,PⅢP)、血骨钙素(bone gla protein,BGP)、成纤维细胞生长因子-23(fibroblast growth factor-23,FGF-23)、骨保护素(osteoclastogenesis inhibitory factor,OPG)水平均小于对照组,差异有统计学意义(P<0.05)。结论血液灌注联合血液透析缓解慢性肾衰竭/尿毒症期患者的脂质代谢紊乱、炎症状态、肾纤维化进程和骨代谢异常,血液灌注联合血液透析的治疗效果较单纯血液透析更好。

Objective To explore the effect of blood perfusion combined with hemodialysis on lipid metabolism,inflammatory status,renal fibrosis index,and bone metabolism in uremia patients with chronic renal failure.Methods The data of 130 uremia patients with chronic renal failure in our hospital from December 2021 to December 2022 were retrospectively analyzed and divided into control group(71 people)and study group(59 people).Control group was given blood perfusion and study group was given blood perfusion combined with hemodialysis.The lipid metabolism,inflammation,renal fibrosis,and bone metabolism of the two groups were compared before and 6 months after treatment.Results After six months treatment,the total cholesterol(total cholesterol,TC),triglyceride(TG),bone morphogenetic protein(BMP),and C-reactive protein(CRP),tumor necrosis factor-ɑ(TNF-ɑ),collagen type IV(Collage Type VI,VI-Col),laminin(LN),N-terminal type III procollagen Peptides(Class III procollagen N peptide,PⅢP),blood osteocalcin(Bone gla protein,BGP),fibroblast growth factor-23(fibroblast growth factor-23,FGF-23),and osteoprotegerin(osteoclastogenesis inhibitory factor,OPG)levels of study group were lower than those of control group,and the difference was statistically significant(P<0.05).Conclusion The combination of blood perfusion and hemodialysis alleviates lipid metabolism disorders,inflammatory status,renal fibrosis progression,and abnormal bone metabolism in patients with chronic renal failure/uremia.The therapeutic effect of blood perfusion combined with hemodialysis is better than that of simple hemodialysis.