血液灌流联合血液滤过对尿毒症患者微炎性状态及营养状态的影响

Effects of Hemoperfusion Combined with Hemofiltration on Microinflammatory Status and Nutritional Status of Uremia Patients

目的:观察血液灌流与血液滤过的联合疗法改善尿毒症患者轻微炎性状态及营养状态的效果。方法:选取中国贵航集团三〇二医院血液净化中心2021年9月—2022年7月收治的105例尿毒症患者为样本,随机将其分配至观察组(n=52)和对照组(n=53)中。观察组接受血液灌流联合血液滤过治疗,对照组接受传统血液滤过治疗。比较两组微炎性指标[C反应蛋白(CRP)、白细胞介素-6(IL-6)水平]、营养状态指标[总蛋白(TP)、白蛋白(Alb)水平,营养不良炎症严重程度评分(MIS)、改良定量整体主观评估(MQSGA)评分]及不良反应发生情况。结果:治疗后,两组CRP、IL-6水平低于治疗前,观察组低于对照组(P<0.05)。治疗后,两组TP、Alb水平高于治疗前,MIS、MQSGA评分低于治疗前,观察组优于对照组(P<0.05)。观察组不良反应总发生率低于对照组(P=0.039)。结论:血液灌流联合血液滤过治疗能够显著改善尿毒症患者的微炎性状态和营养状态,不良反应发生率较低。

Objective:Observe the effect of the combination therapy of hemoperfusion and hemofiltration on improving the mild inflammation and nutritional status in uremia patients.Methods:A total of one hundred and five uremia patients admitted to Blood Purification Center of China Guihang Group 302 Hospital from September 2021 to July 2022 were selected as the study objects,and randomly divided into observation group(n=52)and control group(n=53).The observation group received hemoperfusion combined with hemofiltration,and the control group received traditional hemofiltration.The micro inflammatory indicators[C-reactive protein(CRP),interleukin-6(IL-6)levels],nutritional status indicators[total protein(TP),albumin(Alb)levels,malnutrition inflammation severity score(MIS),modified quantitative global subjective assessment(MQSGA)score]and the occurrence of adverse reactions were compared between the two groups.Results:After treatment,the levels of CRP and IL-6 in two groups were lower than before treatment,and those in observation group were lower than those in control group(P<0.05).After treatment,the levels of TP and Alb in both groups were higher than before treatment,and the scores of MIS and MQSGA were lower than before treatment,and the observation group was better than the control group(P<0.05).The total incidence of adverse reactions in observation group was lower than that in control group(P=0.039).Conclusion:Hemoperfusion combined with hemofiltration can significantly improve the microinflammatory status and nutritional status of uremia patients,and the incidence of adverse reactions is low.