CAJ | 학술논문

目的：探究高运转型肾性骨病患者实施高通量血液透析联合血液灌流方案对其临床症状及生化指标的影响，并积累临床实践经验以优化治疗方案。方法回顾性分析2010年2月至2014年5月收治的85例行血液透析治疗患者，根据其透析方案的不同进行分组，其中对照组实施常规透析疗法（ n =44），研究组实施高通量血液透析联合血液灌流方案（n =41）。记录并比较两组患者透析前及透析后第4个月末的临床症状改善情况以及主要血生化指标情况。结果两组患者治疗前不良症状发生率差异无统计学意义（ P ﹥0.05）；研究组治疗后的肌肉疼痛、骨关节炎、肩周炎及皮肤瘙痒发生率均低于对照组，差异有统计学意义（ P ﹤0.05）。两组患者治疗前的主要血生化指标差异无统计学意义（ P ﹥0.05）；研究组治疗后的磷（P3-）、甲状旁腺激素（iPTH）、β2微球蛋白（β2- MG）及骨钙素（BGP）值均低于对照组，差异有统计学意义（ P ﹤0.05）。结论高通量血液透析联合血液灌流应用于高转运型肾性骨病患者，利于清除大、中毒性分子，改善患者临床症状，使其生活质量得以提高，值得在基层医院推广应用。
목적：탐구고운전형신성골병환자실시고통량혈액투석연합혈액관류방안대기림상증상급생화지표적영향，병적루림상실천경험이우화치료방안。방법회고성분석2010년2월지2014년5월수치적85례행혈액투석치료환자，근거기투석방안적불동진행분조，기중대조조실시상규투석요법（ n =44），연구조실시고통량혈액투석연합혈액관류방안（n =41）。기록병비교량조환자투석전급투석후제4개월말적림상증상개선정황이급주요혈생화지표정황。결과량조환자치료전불량증상발생솔차이무통계학의의（ P ﹥0.05）；연구조치료후적기육동통、골관절염、견주염급피부소양발생솔균저우대조조，차이유통계학의의（ P ﹤0.05）。량조환자치료전적주요혈생화지표차이무통계학의의（ P ﹥0.05）；연구조치료후적린（P3-）、갑상방선격소（iPTH）、β2미구단백（β2- MG）급골개소（BGP）치균저우대조조，차이유통계학의의（ P ﹤0.05）。결론고통량혈액투석연합혈액관류응용우고전운형신성골병환자，리우청제대、중독성분자，개선환자림상증상，사기생활질량득이제고，치득재기층의원추엄응용。
Objective To explore the high transformation of renal osteodystrophy in patients with the implementation of high flux hemodi-alysis union blood perfusion on the clinical symptoms and biochemical indexes of program impact,and the accumulation of clinical experience to optimize the treatment programs. Methods A retrospective analysis of 85 cases of hemodialysis patients treated in our hospital in May 2014 to February 2010 was performed. According to the different groups,the control group received conventional dialysis therapy(n = 44),the research group to implement high flux hemodialysis combined with blood perfusion(n = 41). The clinical symptoms improvement of two groups of patients before and after fourth months of dialysis were recorded and the values of main blood biochemical indexes were compared. Results The occurring rate of two groups of patients before symptoms had no statistical significance( P ﹥ 0. 05). The incidence of study group after treatment,muscle pain,bone arthritis,periarthritis of shoulder and skin itching rates were lower than that of the control group. The difference is statistically signifi-cant( P ﹤ 0. 05). There was no significant difference between the two groups before treatment( P ﹥ 0. 05). The P3,2 - MG,iPTH and BGP values of the study group were significantly lower than those of the control group,the difference was statistically significant( P ﹤ 0. 05). Conclu-sion High flux hemodialysis combined with hemo - perfusion in patients with renal osteodystrophy high transport type,to remove,toxic mole-cules,improve the clinical symptoms of the patients. The quality of life can be improved,is worth to be popularized in basic level hospital.