临床荟萃
臨床薈萃
림상회췌
Clinical Focus
2015年
11期
1292-1295,1296
,共5页
尿毒症%透析%营养不良%炎症
尿毒癥%透析%營養不良%炎癥
뇨독증%투석%영양불량%염증
uremia%dialysis%malnutrition%inflammatory
目的：比较不同透析频率在尿毒症血液透析患者中的应用效果。方法选取2011年1月至2013年12月期间于我院进行血液透析治疗的81例尿毒症患者为研究对象,根据透析频率分为 A 组(每周透析4次,n =19)、B组(每周透析3次,n =33)、C 组(每周透析2次,n =29)。比较3组一般情况、营养状况指标、钙磷代谢状况、微炎症指标、并发症发生率和转归情况。结果开始透析时3组各临床资料比较差异均无统计学意义(P >0.05)。透析1年后,A 组血红蛋白(Hb)显著高于 B 组(P <0.05),A 组血清白蛋白(ALB)、前白蛋白(PA)、Hb 均显著高于 C 组,而血肌酐(SCr)和尿素氮(BUN)均显著低于 C 组(P <0.05),B 组的 ALB、PA 均显著高于 C 组(P <0.05)。A 组的血钙(Ca)显著高于 B 组和 C 组,而血磷(P)、甲状旁腺激素(PTH)显著低于 B 组和 C 组(P <0.05)。A 组的超敏 C 反应蛋白(hs-CRP)、白细胞介素6(IL-6)水平均显著低于 C 组(P <0.05)。A 组的感染发生率和病死率均显著低于 C组(P >0.05)。结论透析频率增加有助于改善营养状况和微炎症状态,降低感染的发生风险,从而改善尿毒症患者的预后,故推荐对每周透析3次的患者增加透析频率,在经济条件允许情况下可采用每周透析4次的高通量透析方案。
目的：比較不同透析頻率在尿毒癥血液透析患者中的應用效果。方法選取2011年1月至2013年12月期間于我院進行血液透析治療的81例尿毒癥患者為研究對象,根據透析頻率分為 A 組(每週透析4次,n =19)、B組(每週透析3次,n =33)、C 組(每週透析2次,n =29)。比較3組一般情況、營養狀況指標、鈣燐代謝狀況、微炎癥指標、併髮癥髮生率和轉歸情況。結果開始透析時3組各臨床資料比較差異均無統計學意義(P >0.05)。透析1年後,A 組血紅蛋白(Hb)顯著高于 B 組(P <0.05),A 組血清白蛋白(ALB)、前白蛋白(PA)、Hb 均顯著高于 C 組,而血肌酐(SCr)和尿素氮(BUN)均顯著低于 C 組(P <0.05),B 組的 ALB、PA 均顯著高于 C 組(P <0.05)。A 組的血鈣(Ca)顯著高于 B 組和 C 組,而血燐(P)、甲狀徬腺激素(PTH)顯著低于 B 組和 C 組(P <0.05)。A 組的超敏 C 反應蛋白(hs-CRP)、白細胞介素6(IL-6)水平均顯著低于 C 組(P <0.05)。A 組的感染髮生率和病死率均顯著低于 C組(P >0.05)。結論透析頻率增加有助于改善營養狀況和微炎癥狀態,降低感染的髮生風險,從而改善尿毒癥患者的預後,故推薦對每週透析3次的患者增加透析頻率,在經濟條件允許情況下可採用每週透析4次的高通量透析方案。
목적：비교불동투석빈솔재뇨독증혈액투석환자중적응용효과。방법선취2011년1월지2013년12월기간우아원진행혈액투석치료적81례뇨독증환자위연구대상,근거투석빈솔분위 A 조(매주투석4차,n =19)、B조(매주투석3차,n =33)、C 조(매주투석2차,n =29)。비교3조일반정황、영양상황지표、개린대사상황、미염증지표、병발증발생솔화전귀정황。결과개시투석시3조각림상자료비교차이균무통계학의의(P >0.05)。투석1년후,A 조혈홍단백(Hb)현저고우 B 조(P <0.05),A 조혈청백단백(ALB)、전백단백(PA)、Hb 균현저고우 C 조,이혈기항(SCr)화뇨소담(BUN)균현저저우 C 조(P <0.05),B 조적 ALB、PA 균현저고우 C 조(P <0.05)。A 조적혈개(Ca)현저고우 B 조화 C 조,이혈린(P)、갑상방선격소(PTH)현저저우 B 조화 C 조(P <0.05)。A 조적초민 C 반응단백(hs-CRP)、백세포개소6(IL-6)수평균현저저우 C 조(P <0.05)。A 조적감염발생솔화병사솔균현저저우 C조(P >0.05)。결론투석빈솔증가유조우개선영양상황화미염증상태,강저감염적발생풍험,종이개선뇨독증환자적예후,고추천대매주투석3차적환자증가투석빈솔,재경제조건윤허정황하가채용매주투석4차적고통량투석방안。
Objective To compare the application effect of different dialysis frequencies in uremic patients. Methods A total of 81 uremic patients who received dialysis from Jan.201 1 to Dec.2013 were enrolled and divided into group A (4 times per week,n =1 9),group B (3 times per week,n =33)and group C (2 times per week,n =29).General condition,nutrition indicators,calcium and phosphorus metabolism,micro-inflammatory indicators, incidence of complications and prognosis were compared among three groups.Results There were no significant difference in all clinical indexes among three groups at the initiation of dialysis (P >0.05 ).One year after dialysis, hemoglobin (Hb)of group A was significantly higher than that of group B (P < 0.05 ).Compared with group C, serum albumin (ALB),pre albumin (PA)and Hb in group A were significantly higher,and serum creatinine (Scr) and blood urea nitrogen (BUN)in group A were significantly lower (P < 0.05 ).ALB and PA in group B were significantly higher than those in group C (P < 0.05 ).Compared with group B and C,the serum calcium was significantly higher and serum phosphorus (P)and parathyroid hormone (PTH)were significantly lower (P <0.05). The high sensitivity C reactive protein (hs-CRP)and interleukin-6 (IL-6 )in group A were significantly lower than those in group C (P <0.05).The incidence of infection and mortality in group A were significantly lower than those in group C (P <0.05).Conclusion Increasing dialysis frequency could help improve the nutritional status and micro-inflammatory state,reduce the risk of infection,and improve the prognosis of uremia patients.It is recommended to increase the dialysis frequency for patients receiving dialysis three times twice weeks,and adopt the high flux dialysis scheme three times a week if economic conditions permit.
