摘要
目的探究不同透析方式治疗尿毒症的临床效果。方法84例接受透析治疗的尿毒症患者,随机分为A组和B组,每组42例。A组以常规高通量血液透析方式治疗,B组在A组基础上联合血液透析滤过方式治疗。比较两组患者心血管不良事件(心力衰竭、心绞痛、心肌梗死)发生率及治疗前后血清炎症因子[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、血管内皮细胞损伤因子[血管性血友病因子(vWF)、可溶性血管细胞粘附分子1(sVCAM-1)]水平。结果B组患者心血管不良事件发生率2.38%低于A组的14.29%,差异有统计学意义(P<0.05)。治疗后,B组患者血清hs-CRP(7.21±2.12)mg/L、IL-6(5.24±1.82)pg/ml、TNF-α(1.16±0.32)pg/ml均低于A组的(10.04±2.32)mg/L、(9.92±2.28)pg/ml、(1.62±0.46)pg/ml,差异有统计学意义(P<0.05)。治疗后,B组患者vWF(16.28±3.85)IU/dl、sVCAM-1(0.77±0.22)μg/ml均低于A组的(23.48±4.32)IU/dl、(1.19±0.42)μg/ml,差异有统计学意义(P<0.05)。结论相较于常规高通量血液透析治疗,尿毒症患者应用血液透析滤过+高通量血液透析治疗效果更优,可改善患者血管内皮细胞功能,减轻机体微炎症状态,降低心血管不良事件发生率。
Objective To investigate the clinical effect of different dialysis methods in the treatment of uremia.Methods A total of 84 uremia patients receiving dialysis were randomly divided into group A and group B,with 42 cases in each group.Group A was treated with conventional high-flux hemodialysis,and group B was treated with hemodialysis filtration on the basis of group A.Both groups were compared in terms of incidence of cardiovascular adverse events(heart failure,angina pectoris,myocardial infarction),the levels of serum inflammatory factors[hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],vascular endothelial cell injury factor[von Willefibrilia factor(vWF),and soluble vascular cell adhesion molecule 1(sVCAM-1)]levels before and after treatment.Results The incidence of cardiovascular adverse events in group B was 2.38%,which was lower than that of 14.29%in group A,and the difference was statistically significant(P<0.05).After treatment,group B had serum hs-CRP of(7.21±2.12)mg/L,IL-6 of(5.24±1.82)pg/ml and TNF-αof(1.16±0.32)pg/ml,which were lower than those of(10.04±2.32)mg/L,(9.92±2.28)pg/ml and(1.62±0.46)pg/ml in group A.The differences were statistically significant(P<0.05).After treatment,vWF of(16.28±3.85)IU/dl and sVCAM-1 of(0.77±0.22)μg/ml in group B were lower than those of(23.48±4.32)IU/dl and(1.19±0.42)μg/ml in group A,and the differences were statistically significant(P<0.05).Conclusion Compared with high-flux hemodialysis,hemodialysis filtration+high-flux hemodialysis is more effective for uremia,which can improve the function of vascular endothelial cells,reduce the micro inflammatory state and reduce the incidence of cardiovascular adverse events.
作者
姜晓华
JIANG Xiao-hua(Department of Endocrinology,Lingyuan Central Hospital,Lingyuan 122500,China)
出处
《中国现代药物应用》
2023年第20期57-59,共3页
Chinese Journal of Modern Drug Application
