两种血液透析方法对尿毒症患者营养状态的影响

目的研究高通量血液透析(HFHD)和低通量血液透析(LFHD)两种方法对尿毒症患者营养状态的影响。方法采用自身对照研究方法对40例维持性低通量血液透析(LFHD)患者,改用HFHD 10个月,分别测定患者血清白蛋白(Alb)、血红蛋白(Hb)、全段甲状旁腺激素(iPTH)及电解质水平,进行主观综合性营养评估(SGA)及食欲评分。结果 40例维持性血液透析(MHD)患者HFHD治疗前后,Alb分别为(38.2±4.4)g/L、(41.5±7.2)g/L,Hb(77.12±4.63)g/L、(101.4±8.67)g/L,iPTH为(654.3±750.1)ng/L、(304.7±898.9)ng/L,血磷(2.34±0.51)mmol/L、(1.68±0.45)mmol/L,SGA评估及食欲评分治疗前较治疗后显著升高,两两比较差异有统计学意义(P<0.05)。结论 HFHD能提高患者的血清白蛋白水平,纠正贫血,降低iPTH及血磷水平,较好地改善患者的营养状态。

Two hemodialysis methods on the nutritional status of patients with uremia

Objective To study the effects of high flux hemodialysis and low-flux hemodialysis two methods on the nutritional status of patients with uremia.Methods In a self-control study,40 patients undergoing maintenance low flux hemodialysis were assigned to receive high-flux hemodialysis for 10 months.Serum albumin（Alb）,the hemoglobin（Hb）,parathyroid hormone（iPTH）,phosphate subjective global assessment（SGA）,and appetite score were measured after 10 months.Results Of 40 patients with maintenance hemodialysis（MHD）,before and after HFHD treatment,Serum Alb was 38.2±4.4 and 41.5±7.2 g/L,Hb was 77.12±4.63 and 101.4±8.67 g/L,iPTH was 654.3±750.1 and 304.7±898.9 ng/L,blood phosphorus was 2.34±0.51 and 1.68±0.45 mmol/L,respectively.SGA and appetite score superiorly increase before and after treatment.All data represent a statistically significant difference（P0.05）.Conclusion MHFD can increase serum albumin levels,hemoglobin levels and reduce parathyroid hormone（iPTH） and phosphate levels,improve nutrition state in uremic patients.