血液透析滤过清除糖尿病肾病合并尿毒症患者小中分子毒素的效果

Effect of Hemodiafiltration on Clearing Small to Medium Molecular Toxins in Patients with Diabetic Nephropathy and Uremia

目的研究血液透析滤过清除糖尿病肾病合并尿毒症患者小中分子毒素的效果。方法方便选取2016年6月—2018年1月期间该院接诊的116例糖尿病肾病合并尿毒症患者作为研究对象,经患者同意后,按照随机分配的方法分为研究组和对照组,各58例。对照组患者采用血液透析进行血液净化治疗;研究组患者采用血液透析滤过进行血液净化治疗。比较分析两组患者治疗后钙离子(Ca2+)、钠离子(Na+)、钾离子(K+)、氯离子(Cl-)清除情况和清除小中分子毒素的效果。结果两组患者治疗后Ca2+浓度均升高,Na+、K+、Cl-、BUN、Cr浓度均下降,且两组患者Ca2+(t=0.467 8,P=0.640 8)、Na+(t=0.638 2,P=0.531 1)、K+(t=1.575 7,P=0.117 9)、Cl-(t=0.257 6,P=0.797 2)、BUN(t=1.930 8,P=0.656 0)、Cr(t=0.449 4,P=0.654 0)浓度水平差异无统计学意义(P>0.05)。两组患者治疗后PTH、β2-MG浓度浓度均下降,且研究组的PTH(t=33.415 7,P=0.000 0)的浓度降低到(123.51±11.85)μg/L、β2-MG(t=27.052 4,P=0.000 0)的浓度降低到(12.88±1.21)μg/L,明显低于对照组,PTH(t=50.473 3,P=0.000 0)的清除率高达(57.61±5.44)%、β2-MG (t=49.987 2,P=0.000 0)的清除率高达(49.81±4.71)%,明显高于对照组,比较差异有统计学意义(P<0.05)。结论该文应用血液透析滤过有效地清除糖尿病肾病合并尿毒症患者小中分子毒素,值得在临床中广泛应用。

Objective To study the effect of hemodiafiltration on the removal of small and medium molecular toxins in patients with diabetic nephropathy and uremia.Methods A total of 116 patients with diabetic nephropathy and uremia who were admitted to our hospital from June 2016 to January 2018 were convenient selected and enrolled.After the patients agreed,they were divided into study group and control group according to the randomization method.The patients in the control group were treated with hemodialysis for blood purification;the patients in the study group were treated with hemodiafiltration for blood purification.The effects of calcium ion(Ca2+),sodium ion(Na+),potassium ion(K+),chloride ion(Cl-)clearance and clearance of small medium molecular toxins were compared between the two groups.Results The Ca2+concentration increased after treatment,and the concentrations of Na+,K+,Cl-,BUN and Cr decreased,and Ca2+(t=0.467 8,P=0.640 8)and Na+(t=0.638 2,P=0.531 1),K+(t=1.575 7,P=0.117 9),Cl-(t=0.257 6,P=0.797 2),BUN(t=1.930 8,P=0.656 0),Cr(t=0.449 4,P=0.654 0),not statistically significant.The concentration of PTH andβ2-MG decreased after treatment in both groups,and the concentration of PTH(t=33.415 7,P=0.000 0)in the study group decreased to(123.51±11.85)μg/L,β2-MG(t=27.052 4,P=0.000 0)decreased to(12.88±1.21)μg/L,which was significantly lower than that of the control group.The clearance rate of PTH(t=50.473 3,P=0.000 0)was as high as(57.61±5.44)%,β2-MG(t=49.987 2,P=0.000 0)was as high as(49.81±4.71)%,which was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion This article applies hemodiafiltration to effectively remove small and medium molecular toxins in patients with diabetic nephropathy and uremia,which is worthy of wide application in clinical practice.