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郑州大学附属郑州中心医院血液净化中心
纸质出版日期:2021,
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陆宜莲, 刘萌萌, 皇甫珍慧. 高通量血液透析治疗对慢性肾功能衰竭患者钙磷代谢及近期预后的影响[J]. 保健医学研究与实践, 2021,18(6):64-68.
Lu Yilian, Liu Mengmeng, Huangfu Zhenhui. Effect of high-flux hemodialysis treatment on calcium and phosphorus metabolism and recent prognosis in patients with chronic renal failure[J]. Health Medicine Research and Practice, 2021,18(6):64-68.
陆宜莲, 刘萌萌, 皇甫珍慧. 高通量血液透析治疗对慢性肾功能衰竭患者钙磷代谢及近期预后的影响[J]. 保健医学研究与实践, 2021,18(6):64-68. DOI:
Lu Yilian, Liu Mengmeng, Huangfu Zhenhui. Effect of high-flux hemodialysis treatment on calcium and phosphorus metabolism and recent prognosis in patients with chronic renal failure[J]. Health Medicine Research and Practice, 2021,18(6):64-68. DOI:
目的分析高通量血液透析治疗对慢性肾功能衰竭(CRF)患者钙磷代谢及近期预后的影响。方法选取2018年3月—2020年7月郑州市某医院收治的CRF患者79例为研究对象
按照治疗方法分为研究组(n=43)和对照组(n=36)。研究组患者给予高通量血液透析治疗
对照组患者给予常规血液透析治疗
均持续治疗12周。比较2组患者的临床疗效、透析充分性[尿素清除指数(KT/V)、尿素时间平均浓度(TACurea)和标准蛋白质分解代谢率(n PCR)]及近期预后的效果
比较2组患者治疗前后钙磷代谢水平、甲状旁腺激素(PTH)水平及肾功能指标[β2-微球蛋白(β2-MG)、血肌酐(SCR)、尿素氮(BUN)]
变化情况。结果研究组患者的治疗总有效率为90.70%
高于对照组的72.22%
差异有统计学意义(χ
2
=4.587
P=0.032)。治疗前
2组患者血钙、血磷及PTH水平比较
差异均无统计学意义(P
>
0.05)。治疗后
2组患者血钙水平高于治疗前
且研究组高于对照组
差异均有统计学意义(P
<
0.05);血磷及PTH水平低于治疗前
且研究组低于对照组
差异均有统计学意义(P
<
0.05)。治疗前
2组患者β2-MG
SCR及BUN水平比较
差异均无统计学意义(P
>
0.05)。治疗后
2组患者β2-MG
SCR及BUN水平低于治疗前
且研究组明显低于对照组
差异均有统计学意义(P
<
0.05)。治疗后
2组患者TACurea比较
差异无统计学意义(P
>
0.05);但研究组患者n PCR低于对照组
KT/V高于对照组
差异均有统计学意义(P
<
0.05)。研究组患者中
无皮肤瘙痒患者占比明显高于对照组
中度皮肤瘙痒患者占比明显低于对照组
差异均有统计学意义(P
<
0.05)。截至随访结束
研究组患者死亡率为13.95%;明显低于对照组(33.33%)
差异有统计学意义(P
<
0.05)。结论高通量血液透析治疗可改善CRF患者残存肾功能
维持钙磷代谢平衡
改善患者近期预后
值得临床推广应用。
Objective To analyze the effects of high-flux hemodialysis treatment on calcium and phosphorus metabolism and recent prognosis in patients with chronic renal failure(CRF). Methods Seventy-nine patients with CRF admitted to a hospital in Zhengzhou from March 2018 to July 2020 were selected as study subjects and divided into study group(n=43) and control group(n=36) according to treatment method. Patients in the study group were given high-flux hemodialysis treatment and patients in the control group were given conventional hemodialysis treatment
both of which were continued for 12 weeks. The clinical efficacy
dialysis adequacy [urea clearance index(KT/V)
time-averaged urea concentration(TACurea) and normalized protein catabolic rate(n PCR)] and near-term prognosis of the patients in the 2 groups were compared
and the calcium and phosphorus metabolism levels
parathyroid hormone(PTH) levels and renal function indexes [β2-microglobulin(β2-MG)
serum creatinine(SCR)
blood urea nitrogen(BUN)]
of patients before and after treatment were compared as well. Results The total effective rate of treatment in the study group was 90.70%
which was higher than that of the control group(72.22%)
and the difference was statistically significant(χ
2
=4.587
P=0.032). Before treatment
there was no statistically significant difference between the levels of blood calcium
blood phosphorus and PTH between the 2 groups(P
>
0.05). After treatment
the blood calcium levels of both groups were higher than before treatment
and the study group was higher than the control group
and the differences were statistically significant(P
<
0.05); the blood phosphorus and PTH levels were lower than before treatment
and the study group was lower than the control group
and the differences were statistically significant(P
<
0.05). Before treatment
there were no statistically significant differences in the levels of β2-MG
SCR and BUN between the 2 groups(P
>
0.05). After treatment
the levels of β2-MG
SCR and BUN in both groups were lower than those before treatment
and the study group was significantly lower than the control group
and the differences were statistically significant(P
<
0.05). After treatment
there was no statistically significant difference in TACurea between the 2 groups(P
>
0.05); however
the n PCR of patients in the study group was lower than that of the control group
and the KT/V was higher than that of the control group
and the differences were all statistically significant(P
<
0.05). Among the patients in the study group
patients without pruritus were significantly more than the control group
and patients with moderate pruritus were significantly less than the control group
and all differences were statistically significant(P
<
0.05). By the end of follow-up
the mortality rate of patients in the study group was 13.95%
and it was significantly lower than that of the control group(33.33%
P
<
0.05). Conclusion High-flux hemodialysis treatment can improve the residual renal function of CRF patients
maintain the balance of calcium and phosphorus metabolism
and improve the near-term prognosis of patients
which is worthy of clinical promotion and application.
高通量血液透析慢性肾功能衰竭钙磷代谢近期预后肾功能
High-flux hemodialysisChronic renal failureCalcium and phosphorus metabolismNear-term prognosisRenal function
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