高通量与低通量血液透析在老年维持性血液透析患者中的应用效果比较

Comparison of application effects of high flux and low flux hemodialysis in elderly patients with maintenance hemodialysis

目的:比较高通量与低通量血液透析在老年维持性血液透析患者中的应用效果。方法:回顾性分析2019年1-12月该院收治的103例老年维持性血液透析患者的临床资料,根据透析模式不同将其分为对照组(n=40)和观察组(n=63)。对照组采用低通量血液透析,观察组采用高通量血液透析。比较两组治疗前后血清学指标[血尿素氮(BUN)、血肌酐(Scr)、甲状旁腺激素(PTH)、β2-微球蛋白(β2-MG)]水平、钙磷代谢指标(血钙、血磷、钙磷乘积)水平、炎性因子[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)]水平、冠脉钙化评分,以及并发症发生率。结果:两组BUN、Scr、β2-MG、PTH水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组血钙、血磷、钙磷乘积水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组IL-10水平均高于治疗前,且观察组高于对照组,两组hs-CRP、TNF-α水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组冠脉钙化评分均高于治疗前,但观察组低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为9.52%(6/63),低于对照组的27.50%(11/40),差异有统计学意义(P<0.05)。结论:高通量血液透析应用于老年维持性血液透析患者可提高冠脉钙化评分,改善炎性因子水平,以及降低血清学指标水平、钙磷代谢指标水平和并发症发生率的效果优于低通量血液透析治疗。

Objective:To compare application effects of high flux and low flux hemodialysis in elderly patients with maintenance hemodialysis.Methods:The clinical data of 103 elderly patients with maintenance hemodialysis admitted to the hospital from January to December 2019 were retrospectively analyzed.According to different dialysis modes,they were divided into control group(n=40)and observation group(n=63).The control group was treated with low flux hemodialysis,while the observation group was treated with highflux hemodialysis.The levels of serological indexes[blood urea nitrogen(BUN),serum creatinine(Scr),parathyroid hormone(PTH),β2-microglobulin(β2-MG)],calcium and phosphorus metabolism indexes(blood calcium,blood phosphorus,calcium-phosphorus product)and inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-10(IL-10)],the coronary calcification score before and after the treatment,and the incidence of complications were compared between the two groups.Results:After the treatment,the levels of BUN,Scr,β2-MG and PTH in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of blood calcium,blood phosphorus and calcium-phosphorus product in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of IL-10 in the two groups were higher than those before the treatment,and that in the observation group was higher than that in the control group;the levels of hs-CRP and TNF-αin the two groups were lower than those before the treatment,and those in the observation group were lower than those in the control group;and the differences were statistically significant(P<0.05).After the treatment,the coronary calcification scores of the two groups were higher than those before the treatment,but that in the observation group was lower than that in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 9.52%(6/63),which was lower than 27.50%(11/40)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Highflux hemodialysis in the elderly maintenance hemodialysis patients can improve the coronary calcification scores,improve the levels of inflammatory factors,and reduce the levels of serological indexes and calcium and phosphorus metabolism indexes as well as the incidence of complications.Moreover,it is superior to lowflux hemodialysis.