[1]李　佳,李庆超,路　华.高通量血液透析与低通量血液透析对重症肾衰竭患者肾功能及预后的影响[J].新乡医学院学报,2022,39(1):071-75.[doi:10.7683/xxyxyxb.2022.01.015]
　LI Jia,LI Qingchao,LU Hua.Effect of high flux hemodialysis and low flux hemodialysis on renal function and prognosis of patients with severe renal failure[J].Journal of Xinxiang Medical University,2022,39(1):071-75.[doi:10.7683/xxyxyxb.2022.01.015]
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高通量血液透析与低通量血液透析对重症肾衰竭患者肾功能及预后的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
39
期数:
2022年1
页码:
071-75
栏目:
临床研究
出版日期:
2022-01-05

文章信息/Info

Title:
Effect of high flux hemodialysis and low flux hemodialysis on renal function and prognosis of patients with severe renal failure
作者:
李　佳; 李庆超; 路　华
（中国人民解放军海军第九七一医院肾脏病科,山东　青岛　266000）
Author(s):
LI Jia; LI Qingchao; LU Hua
（Department of Nephrology,the 971st PLA Naval Hospital,Qingdao 266000,Shandong Province,China）
关键词:
高通量血液透析; 低通量血液透析; 重症肾衰竭; 生存率
Keywords:
high flux hemodialysislow flux hemodialysissevere renal failuresurvival rate
分类号:
R692
DOI:
10.7683/xxyxyxb.2022.01.015
文献标志码:
A
摘要:
目的　探讨高通量血液透析与低通量血液透析对重症肾衰竭患者肾功能及预后的影响。方法　选择2015年1月至2018年12月中国人民解放军海军第九七一医院收治的重症肾衰竭患者120例为研究对象，根据透析方法将患者分为对照组和观察组，每组60例。对照组患者给予低通量血液透析治疗，观察组患者给予高通量血液透析治疗，2组患者均治疗3个月。分别于治疗前和治疗后采用全自动生物化学分析仪检测血肌酐（Scr）、内生肌酐（Ccr）、尿素氮（BUN）及总蛋白（TP）、白蛋白（ALB）、β2-微球蛋白（β2-MG）水平，采用化学免疫法检测血清中白细胞介素-6（IL-6）、高敏C-反应蛋白（hs-CRP）、肿瘤坏死因子-α (TNF-α)水平。记录2组患者治疗前后24 h尿量，计算治疗前后残肾功能（RRF）。记录并比较2组患者并发症发生情况和1 a 生存率。结果　治疗前2组患者的Scr、Ccr、BUN水平比较差异均无统计学意义（P>0.05）。与治疗前比较，治疗后2组患者的Scr、BUN水平下降，Ccr水平升高（P<0.05）；治疗后，观察组患者的 Scr、BUN水平低于对照组，Ccr水平高于对照组（P<0.05）。治疗前2组患者的24 h 尿量和RRF比较差异无统计学意义（P>0.05）。治疗后，2组患者的24 h尿量和RRF均低于治疗前（P<0.05）；且对照组患者的24 h尿量和RRF低于观察组（P<0.05）。治疗前2组患者血清中IL-6、hs-CRP、TNF-α水平比较差异均无统计学意义（P>0.05）。治疗后，2组患者血清中IL-6、hs-CRP、TNF-α水平均低于治疗前（P<0.05）；且观察组患者的IL-6、hs-CRP、TNF-α水平低于对照组（P<0.05）。治疗前2组患者的TP、ALB、β2-MG水平比较差异均无统计学意义（P>0.05）。治疗后，2组患者的TP、ALB水平高于治疗前，β2-MG水平低于治疗前（P<0.05）；且观察组患者的TP、ALB水平高于对照组，β2-MG水平低于对照组（P<0.05）。对照组和观察组患者并发症发生率分别为 31.67%（19/60）、10.00%（6/60），观察组患者的并发症发生率显著低于对照组（χ2=8.540，P<0.05）。对照组和观察组患者的1 a生存率分别为83.33%（50/60）、95.00%（57/60），观察组患者的1 a生存率显著高于对照组（χ2=1.250，P<0.05）。结论　高通量血液透析可有效清除重症肾衰竭患者体内的毒素分子，降低机体的炎症反应，保护RRF，患者1 a生存率较高。
Abstract:
Objective　To explore the effect of high flux hemodialysis and low flux hemodialysis on the renal function and prognosis of patients with severe renal failure.Methods　A total of 120 patients with severe renal failure in the 971st PLA Naval Hospital from January 2015 to December 2018 were selected as the research objects.The patients were divided into the observation group and the control group according to dialysis methods，with 60 patients in each group.The patients in the observation group and control group were treated with high flux hemodialysis and low flux hemodialysis,respectivelyall patients were treated for 3 months.Before and after treatment,the serum creatinine(Scr),endogenous creatinine(Ccr),urea nitrogen(BUN) and total protein (TP),albumin(ALB),β2-microglobulin(β2-MG) levels of patients in the two groups were detected by automatic biochemical analyzerthe levels of serum interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α) of patients in the two groups were detected by chemical immunoassay.The 24 h urine volume of patients in the two groups was recorded before and after treatment,and the residual renal function (RRF) was calculated before and after treatment.The complications and 1-year survival rate were recorded and compared between the two groups.Results　There was no significant difference in the levels of Scr,Ccr and BUN of patients between the two groups before treatment (P>0.05).Compared with before treatment,the levels of Scr and BUN decreased and the level of Ccr increased in the two groups after treatment (P<0.05)after treatment,the levels of Scr and BUN of patients in the observation group were lower than those in the control group,and the level of Ccr was higher than that in the control group (P<0.05).There was no significant difference in 24 h urine volume and RRF of patients between the two groups before treatment (P>0.05).The 24 h urine volume and RRF of patients after treatment were lower than those before treatment in the two groups (P<0.05)the 24 h urine volume and RRF of patients in the control group were lower than those in the observation group after treatment (P<0.05).There was no significant difference in serum levels of IL-6,hs-CRP and TNF-α of patients between the two groups before treatment (P>0.05).The levels of serum IL-6,hs-CRP and TNF-α of patients after treatment were lower than those before treatment in the two groups (P<0.05)the levels of serum IL-6,hs-CRP and TNF-α of patients in the observation group were lower than those in the control group after treatment(P<0.05).There was no significant difference in TP,ALB and β2-MG levels of patients between the two groups before treatment (P>0.05).Compared with before treatment,the levels of TP,ALB increased,and the level of β2-MG decreased in the two groups after treatment (P<0.05).After treatment,the levels of TP,ALB of patients in the observation group were higher than those in the control group,and the level of β2-MG of patients in the observation group were lower than those in the control group(P<0.05).The incidence of complications of patients in the control group and the observation group was 31.67% (19/60),10.00% (6/60),respectivelythe incidence of complications of patients in the observation group was significantly lower than that in the control group (χ2=8.540,P<0.05).The 1-year survival rates of patients in the control group and the observation group were 83.33% (50/60) and 95.00% (57/60),respectivelythe 1-year survival rate of patients in the observation group was significantly higher than that in the control group (χ2=1.250,P<0.05).Conclusion　High flux hemodialysis can effectively remove the toxin molecules in patients with severe renal failure,reduce the inflammatory reaction of the body,protect the RRF,and the 1-year survival rate of patients is high.

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更新日期/Last Update: 2022-01-05