维持性血液透析病人高通量透析频率的选择及炎性细胞因子、钙磷代谢指标检测比较
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摘要
目的:分析比较维持性血液透析病人高通量透析频率的选择对炎性细胞因子、钙磷代谢指标检测结果的影响。方法:随机选取55例维持性血透高通量透析病人作为研究对象,按照随机数字法分为A组(28例,透析频率4次/周)和B组(27例,透析频率3次/周)。分别于治疗前后测定2组病人的肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)等血清炎性细胞因子指标及钙磷代谢水平,比较2组临床疗效和感染发生情况,随访3个月采用美国波士顿健康研究所研制的简明健康测量量表(SF-36)中文版对2组病人的生活质量水平进行评价。结果:2组治疗后TNF-α、IL-6、hs-CRP水平均较治疗前明显改善,治疗后A组各指标均明显优于B组(P<0.05～P<0.01)。2组治疗后血钙、血磷、钙磷乘积等指标均较治疗前明显改善(P<0.01);治疗后A组钙磷乘积指标优于B组(P<0.01),而血钙和血磷差异无统计学意义(P>0.05)。A组病人临床治疗总有效率明显高于B组(P<0.05),2组病人感染发生率差异无统计学意义(P>0.05)。A组病人随访3个月后的SF-36评分明显高于B组(P<0.01)。结论:维持性血液透析病人高通量透析频率的增加能够有效改善病人血清炎性细胞因子及钙磷代谢水平,且不会增加感染风险,对病人生活质量的提高具有重要意义。
Objective:To analyze and compare the choice of high-flux dialysis frequency in maintenance hemodialysis patients and its influence on the detection results of inflammatory cytokines and calcium and phosphorus metabolic indicators.Methods:Fifty-five patients with maintenance hemodialysis and high flux dialysis were randomly selected as the study subjects,According to the random number method,the patients were divided into group A(28 cases,dialysis frequency 4 times per week) and group B(27 cases,dialysis frequency 3 times per week).The levels of serum inflammatory cytokines such as tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),hypersensitive C reactive protein(hs-CRP) and calcium and phosphorus metabolism were measured before and after treatment,the clinical efficacy of the two groups was compared,and the incidence of infection in the two groups was statistically analyzed.The Chinese version of SF-36 developed by Boston Institute of Health(Boston Institute of Health) was used to evaluate the quality of life of the two groups.Results:The levels of TNF-α,IL-6,hs-CRP inflammatory cytokines and serum calcium,phosphorus and calcium-phosphorus product were significantly improved after treatment in two groups,after treatment,all indexes in group A were significantly better than those in group B(P<0.05 to P<0.01).The total clinical effective rate and SF-36 score of group A were significantly higher than those of group B(P<0.01),but there was no significant difference in the incidence of infection between the two groups(P>0.05).Conclusions:The increase of high flux dialysis frequency in maintenance hemodialysis patients can effectively improve the level of serum inflammatory cytokines and calcium and phosphorus metabolism,and does not increase the risk of infection.It is of great significance to improve the quality of life of patients.
Objective:To analyze and compare the choice of high-flux dialysis frequency in maintenance hemodialysis patients and its influence on the detection results of inflammatory cytokines and calcium and phosphorus metabolic indicators.Methods:Fifty-five patients with maintenance hemodialysis and high flux dialysis were randomly selected as the study subjects,According to the random number method,the patients were divided into group A(28 cases,dialysis frequency 4 times per week) and group B(27 cases,dialysis frequency 3 times per week).The levels of serum inflammatory cytokines such as tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),hypersensitive C reactive protein(hs-CRP) and calcium and phosphorus metabolism were measured before and after treatment,the clinical efficacy of the two groups was compared,and the incidence of infection in the two groups was statistically analyzed.The Chinese version of SF-36 developed by Boston Institute of Health(Boston Institute of Health) was used to evaluate the quality of life of the two groups.Results:The levels of TNF-α,IL-6,hs-CRP inflammatory cytokines and serum calcium,phosphorus and calcium-phosphorus product were significantly improved after treatment in two groups,after treatment,all indexes in group A were significantly better than those in group B(P<0.05 to P<0.01).The total clinical effective rate and SF-36 score of group A were significantly higher than those of group B(P<0.01),but there was no significant difference in the incidence of infection between the two groups(P>0.05).Conclusions:The increase of high flux dialysis frequency in maintenance hemodialysis patients can effectively improve the level of serum inflammatory cytokines and calcium and phosphorus metabolism,and does not increase the risk of infection.It is of great significance to improve the quality of life of patients.
引文
[1] NAALWEH KS,BARAKAT MA,SWEILEH MW,et al.Treatment adherence and perception in patients on maintenance hemodialysis:a cross-sectional study from Palestine[J].BMC Nephrol,2017,18(1):178.
[2] 付春艳,王沂芹,王代红,等.血液透析联合血液灌流对维持性血液透析患者微炎性因子及钙磷代谢的影响[J].海南医学院学报,2015,21(1):56.
[3] BORZYCH-DUZALKA D,SHROFF R,LIM YN,et al.Predominance of central venous lines (CVL) in pediatric hemodialysis (HD) despite much higher complication rates-Report from the International Pediatric Hemodialysis Network (IPHN)[J].Pediatr Nephrol,2016,31(10):1743.
[4] 王伟,岳华.不同透析频率对维持性血液透析患者营养状况和钙磷代谢的影响[J].中华肾脏病杂志,2014,30(8):627.
[5] 邵玲就,刘琦.高通量透析对维持性血液透析患者钙磷代谢及血脂的影响[J].浙江医学,2014,36(11):958.
[6] 蓝天座,闵亚丽,樊丰夷,等.高通量透析联合不同频率血液灌流对维持性血液透析患者微炎症状态和钙磷代谢的影响[J].实用医院临床杂志,2016,13(3):50.
[7] SHAH A,BROSS R,SHAPIRO BB,et al.Dietary energy requirements in relatively healthy maintenance hemodialysis patients estimated from long-term metabolic studies[J].Am J Clin Nutr,2016,103(3):757.
[8] BEBERASHVILI I,ERLICH A,AZAR A,et al.Longitudinal study of serum uric acid,nutritional status,and mortality in maintenance hemodialysis patients[J].Clin J Am Soc Nephrol,2016,11(6):1015.
[9] 董雄军.高通量透析对维持性血液透析患者钙磷代谢影响[J].安徽医学,2015,36(6):733.
[10] 蔡艳,白云霞,张永新,等.高通量透析对维持性血液透析患者钙磷代谢的影响[J].昆明医科大学学报,2014,35(9):141.
[11] 张月,洪大情,高辉,等.维持性血液透析患者心脏结构功能的改变及其相关因素分析[J].实用医院临床杂志,2013,10(6):32.
[12] 肖健,马兵,石平.高通量透析对维持性血液透析患者钙磷代谢的影响[J].临床肾脏病杂志,2016,16(8):487.
[13] 罗进辉.血液灌流频率差异对行维持性血液透析患者炎性细胞因子水平、钙磷代谢及感染风险的影响[J].河北医药,2017,39(6):850.
[2] 付春艳,王沂芹,王代红,等.血液透析联合血液灌流对维持性血液透析患者微炎性因子及钙磷代谢的影响[J].海南医学院学报,2015,21(1):56.
[3] BORZYCH-DUZALKA D,SHROFF R,LIM YN,et al.Predominance of central venous lines (CVL) in pediatric hemodialysis (HD) despite much higher complication rates-Report from the International Pediatric Hemodialysis Network (IPHN)[J].Pediatr Nephrol,2016,31(10):1743.
[4] 王伟,岳华.不同透析频率对维持性血液透析患者营养状况和钙磷代谢的影响[J].中华肾脏病杂志,2014,30(8):627.
[5] 邵玲就,刘琦.高通量透析对维持性血液透析患者钙磷代谢及血脂的影响[J].浙江医学,2014,36(11):958.
[6] 蓝天座,闵亚丽,樊丰夷,等.高通量透析联合不同频率血液灌流对维持性血液透析患者微炎症状态和钙磷代谢的影响[J].实用医院临床杂志,2016,13(3):50.
[7] SHAH A,BROSS R,SHAPIRO BB,et al.Dietary energy requirements in relatively healthy maintenance hemodialysis patients estimated from long-term metabolic studies[J].Am J Clin Nutr,2016,103(3):757.
[8] BEBERASHVILI I,ERLICH A,AZAR A,et al.Longitudinal study of serum uric acid,nutritional status,and mortality in maintenance hemodialysis patients[J].Clin J Am Soc Nephrol,2016,11(6):1015.
[9] 董雄军.高通量透析对维持性血液透析患者钙磷代谢影响[J].安徽医学,2015,36(6):733.
[10] 蔡艳,白云霞,张永新,等.高通量透析对维持性血液透析患者钙磷代谢的影响[J].昆明医科大学学报,2014,35(9):141.
[11] 张月,洪大情,高辉,等.维持性血液透析患者心脏结构功能的改变及其相关因素分析[J].实用医院临床杂志,2013,10(6):32.
[12] 肖健,马兵,石平.高通量透析对维持性血液透析患者钙磷代谢的影响[J].临床肾脏病杂志,2016,16(8):487.
[13] 罗进辉.血液灌流频率差异对行维持性血液透析患者炎性细胞因子水平、钙磷代谢及感染风险的影响[J].河北医药,2017,39(6):850.