摘要
目的比较血液透析滤过(HDF)、高通量血液透析(HFHD)对尿毒症患者心肾功能及血清炎症因子水平的影响。方法抽取2019年2月至2021年5月焦作煤业(集团)有限责任公司中央医院收治的尿毒症患者106例。按照血液净化模式将其分为HDF组和HFHD组,每组53例。在常规治疗基础上,HDF组给予HDF方案,HFHD组给予HFHD方案,比较两组治疗后心功能指标[心肌肌钙蛋白T(cTnT)、B型脑钠肽(BNP)、左心室射血分数(LVEF)]、肾功能指标[血清肌酐(Scr)、血尿素氮(BUN)]、血清炎症因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]水平及治疗效果。结果治疗后,HFHD组血清cTnT[(0.14±0.06)μg/L]、BNP[(253.16±48.75)ng/L]、Scr[(608.21±157.39)μmol/L]、BUN[(20.03±4.15)mmol/L]、CRP[(4.75±1.31)mg/L]、TNF-α[(20.34±4.86)pg/ml]、IL-6[(2.97±1.02)ng/ml]水平均低于HDF组[(0.32±0.15)μg/L、(359.70±50.08)ng/L、(679.26±165.31)μmol/L、(22.57±4.83)mmol/L、(5.36±1.42)mg/L、(26.43±5.21)pg/ml、(3.58±1.43)ng/ml],P均<0.05。HFHD组LVEF[(59.83±6.74)%]、治疗总有效率(79.25%,42/53)高于HDF组[(52.73±6.89)%、58.49%(31/53)],差异有统计学意义(P<0.05)。结论HFHD治疗尿毒症可有效改善患者心肾功能,降低炎症因子水平,清除血管内毒素,缓解机体内炎症反应。
Objective To compare the effects of hemodiafiltration(HDF)and high-flux hemodialysis(HFHD)on cardiac and renal function and levels of serum inflammatory cytokines in patients with uremia.Methods A total of 106 patients with uremia admitted to the Central Hospital of Jiaozuo Coal Industry(Group)Co.,Ltd.from February 2019 to May 2021 were selected.According to the blood purification modes,the patients were divided into HDF group and HFHD group,with 53 cases in each group.Based on the conventional treatment,the HDF group was treated by HDF,the HFHD group was treated by HFHD.After treatment,the cardiac function indexes including cardiac troponin T(cTnT),B-type brain natriuretic peptide(BNP)and left ventricular ejection fraction(LVEF),renal function indexes including serum creatinine(Scr)and blood urea nitrogen(BUN),levels of serum inflammatory cytokines including C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6),and therapeutic effects were compared between the two groups.Results After treatment,the serum levels of cTnT,BNP,Scr,BUN,CRP,TNF-αand IL-6 in the HFHD group were(0.14±0.06)μg/L,(253.16±48.75)ng/L,(608.21±157.39)μmol/L,(20.03±4.15)mmol/L,(4.75±1.31)mg/L,(20.34±4.86)pg/ml and(2.97±1.02)ng/ml,respectively,lower than the(0.32±0.15)μg/L,(359.70±50.08)ng/L,(679.26±165.31)μmol/L,(22.57±4.83)mmol/L,(5.36±1.42)mg/L,(26.43±5.21)pg/ml,and(3.58±1.43)ng/ml in the HDF group correspondingly,and the differences were statistically significant(P<0.05).The LVEF and total effective rate in the HFHD group were(59.83±6.74)%and 79.25%(42/53),respectively,higher than the(52.73±6.89)%and 58.49%(31/53)of the HDF group,and the differences were statistically significant(P<0.05).Conclusions HFHD in the treatment of uremia can effectively improve the cardiac and kidney function,reduce inflammatory cytokines levels,remove vascular endotoxin,and relieve the inflammatory response in the body.
作者
姜波
陈惠霞
李疆莉
Jiang Bo;Chen Huixia;Li Jiangli(Department of Nephrology,Central Hospital of Jiaozuo Coal Industry(Group)Co.,Ltd.,Jiaozuo 454000,China;Blood Purification Room,Central Hospital of Jiaozuo Coal Industry(Group)Co.,Ltd.,Jiaozuo 454000,China)
出处
《中国实用医刊》
2022年第22期62-65,共4页
Chinese Journal of Practical Medicine
