血液灌流联合血液透析对尿毒症患者钙磷代谢紊乱和微炎症状态的影响

发布时间：2018-02-24 06:11

本文关键词： 血液灌流血液透析尿毒症钙磷代谢紊乱心脏瓣膜钙化微炎症状态　出处：《中国老年学杂志》2017年16期 　论文类型：期刊论文

【摘要】：目的探讨血液灌流(HP)联合血液透析(HD)对尿毒症患者钙磷代谢紊乱和微炎症状态的影响。方法将70例尿毒症患者按随机数字表法分为HP+HD组和HD组各35例。治疗并随访12个月,观察两组患者治疗前和治疗12个月后的血钙、血磷、甲状旁腺激素(PTH)、β_2-微球蛋白(β_2-MG)及炎症因子:超敏C反应蛋白(hs-CRP)、白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α、脂蛋白(a)[Lp(a)]的变化,比较两组患者心脏瓣膜钙化患病率。结果治疗12个月后,HP+HD组脱失3例,完成32例;HD组脱失5例,完成30例。HP+HD组患者的血磷、PTHβ_2-MG水平均显著低于HD组(t=5.633 8,30.291,9.668 3,均P0.01);两组患者的血钙水平无统计学差异(P0.05);HP+HD组患者的血磷、PTH及β2-MG水平均显著低于HD组(均P0.01);两组患者的血钙水平无统计学差异(P0.05);HP+HD组患者的炎症因子[hs-CRP、IL-6、TNF-α、Lp(a)]水平均显著低于HD组(t=8.353 5,7.311 3,4.638 8,3.534 1,均P0.01)及其治疗前(均P0.01);HP+HD组患者的心脏瓣膜钙化患病率显著低于HD组(χ~2=6.452 4,P0.01)。结论 HP+HD能有效地清除血磷、PTH、β_2-MG及炎症因子,降低心脏瓣膜钙化患病率,其疗效优于单纯的HD治疗。
[Abstract]:Objective to investigate the effect of hemoperfusion with hemodialysis (HD) on calcium and phosphorus metabolism disorder and microinflammation in uremic patients. Methods 70 patients with uremia were randomly divided into HP HD group and HD group with 35 cases each and followed up for 12 months. The changes of serum calcium, phosphorus, parathyroid hormone PTHH, 尾 2-MGG and inflammatory factors (Hs-CRPU, IL-6, TNF- 伪, lipoprotein a) were observed before and 12 months after treatment in both groups. Results after 12 months of treatment, 3 patients in HP HD group lost 3 patients, and 5 patients lost heart valve calcification in 32 patients with HD group. The levels of PTH 尾 2-MG in 30 patients with HP HD were significantly lower than those in HD group (P 0.01), and the levels of PTH and 尾 2-MG in patients with HP HD were significantly lower than those in HD (P 0.01). There was no significant difference in serum calcium levels. The levels of inflammatory factors (hs-CRPnIL-6TNF- 伪) in HD group were significantly lower than those in HD group (8.353 57.37.311), 4.638 83.534 1 (P 0.01) and before treatment (P 0.011). The prevalence of cardiac valve calcification in HD group was significantly lower than that in HD group (蠂 2 6.452 4m P 1). HP HD can effectively remove PTH, 尾 2-MG and inflammatory factors. Reducing the incidence of cardiac valve calcification is better than HD alone.
【作者单位】：宜宾市第二人民医院南区肾病内科;
【基金】：宜宾市科学技术研究项目(No.200803001)
【分类号】：R692.5

【相似文献】