摘要
目的研究混合稀释血液透析滤过(HDF)模式对维持性血液透析(MHD)患者的应用优势。方法共纳入132例MHD患者,将其分为前稀释HDF组(44例)、后稀释HDF组(44例),混合稀释HDF组(44例),对比研究3组患者的尿毒素、炎症因子清除效果,瘙痒、骨痛缓解程度及不良反应发生率。结果治疗6个月后,混合稀释HDF组血磷(P)、血肌酐(Scr)、尿素氮(BUN)、β2微球蛋白(β2-MG)、甲状旁腺激素(iPTH)、C反应蛋白(CRP)均低于前稀释HDF组、后稀释HDF组,差异有统计学意义(P:均P<0.001;Scr:P=0.009、0.011;BUN:P=0.004、0.011;β2-MG:P=0.004、0.004;iPTH:P=0.014、0.023;CRP:均P<0.001);3组患者瘙痒、骨痛程度均有所缓解,缓解率:混合稀释HDF组>前稀释HDF组>后稀释HDF组(2.08%>1.89%>1.59%,4.73%>4.17%>3.98%),差异有统计学意义(P<0.05);治疗期间,不良反应发生率:后稀释HDF组>前稀释HDF组>混合稀释HDF组(13.63%>9.09%>6.89%),差异有统计学意义(P<0.05);3组均未发生过敏反应。结论MHD治疗可明显改善患者微炎症状态、尿毒素水平及瘙痒、骨痛不适,且不良反应发生率较低,其中以混合稀释HDF模式透析效率及安全性最高。
Objective To study the advantages of mixed dilution hemodialysis filtration(HDF)mode for maintenance hemodialysis(MHD)patients.Methods A total of 132 MHD patients were included and divided into the pre-dilution HDF group(44 patients),the post-dilution HDF group(44 patients),and the mixed dilution HDF group(44 patients).The effects of toxin and inflammatory factor clearance,the degree of relief of pruritus and bone pain and the incidence of adverse effects in the three groups were compared and studied.Results After 6 months of treatment,the levels blood phosphorus(P),blood creatinine(Scr),urea nitrogen(BUN),β2 microglobulin(β2-MG),parathyroid hormone(iPTH)and C-reactive protein(CRP)in the mixed dilution HDF group were lower than those in the pre-dilution HDF group and post-dilution HDF group,and the differences were statistically significant.(P:all P<0.001;Scr:P=0.009,0.011;BUN:P=0.004,0.011;β2-MG:P=0.004,0.004;iPTH:P=0.014,0.023;CRP:all P<0.001).The pruritus and bone pain was relieved in all three groups,and the remission rate:mixed diluted HDF group>pre-diluted HDF group>post-diluted HDF group(2.08%>1.89%>1.59%,4.73%>4.17%>3.98%),the differences were statistically significant(P<0.05).During the treatment period,the incidence of adverse reactions:post-dilution HDF group>pre-dilution HDF group>mixed dilution HDF group(13.63%>9.09%>6.89%),the differences were statistically significant(P<0.05).No allergic reactions occurred in all three groups.Conclusion MHD treatment significantly improved the patients′microinflammatory status,urinary toxin level and relief pruritus and bone pain,and incidence of adverse reactions was low,with the highest efficiency and safety of dialysis in the mixed dilution HDF mode.
作者
杨影
唐建英
牟娇
曾薇
王婧
杨璐
YANG Ying;TANG Jianying;MOU Jiao;ZENG Wei;WANG Jing;YANG Lu(Nephrology and Urology Center,University Town Hospital Affiliated to Chongqing Medical University,Chongqing 401331,China)
出处
《重庆医学》
CAS
2022年第7期1117-1121,共5页
Chongqing medicine
基金
重庆市自然科学基金基础研究与前沿探索专项项目(cstc2018jcyjAX0834)。
关键词
血液透析滤过
前稀释
后稀释
混合稀释
hemodiafiltration
pre-dilution
post-dilution
mixed dilution
