血液透析与血液灌流联合治疗对长期血液透析患者微炎性因子及钙磷代谢的影响

目的探讨血液透析与血液灌流联合治疗对长期血液透析患者微炎性因子及钙磷代谢的影响。方法选择2009年1月至2011年12月在长沙市第一医院收治的维持性血液透析患者98例,按随机数字表法分为对照组和观察组,各49例。对照组采用血液透析治疗,观察组采用血液透析与血液灌流联合治疗。观察两组治疗前、治疗6个月时血清CRP、Hb、Alb、TC、TG、BUN、Scr以及血钙、血磷、1,25-(OH)2D3、FGF-23、iPTH改善情况。结果治疗6个月时观察组患者CRP、Hb、Alb、TC、TG水平较本组治疗前及对照组治疗后明显改善,差异有统计学意义(P<0.05);两组治疗前后血清BUN、Scr水平变化的差异无统计学意义(P>0.05);观察组患者血磷、血清FGF-23、iPTH均较治疗前下降,差异具有统计学意义(P<0.05),血清1,25-(OH)2D3较治疗前升高,差异有统计学意义(P<0.01)。结论定期采用血液透析与血液灌流联合治疗长期血液透析患者,有助于改善机体微炎症状态,维持钙磷代谢平衡,进一步提高患者的生活质量和存活率,值得临床推广应用。

Effect of Hemodialysis and Hemoperfusion Combined Therapy on Micro-inflammatory Factor and Calcium Phosphorus Metabolism of Patients with Long-term Hemodialysis

Objective To discuss the effect of hemodialysis and hemoperfusion combined therapy on micro inflammatory factor and calcium phosphorus metabolism patients with long-term hemodialysis.Methods From January 2009 to December 2011,98 cases of maintained hemodialysis patients from Changsha City First Hospital were randomly(radom number table) divided into control group and observation group,49 cases in each group.The control group was treated with hemodialysis(HD),the observation group by hemodialysis and hemoperfusion combined therapy.The changes of serum CRP,Hb,Alb,TC,TG,BUN,Scr and blood calcium,phosphorus,1,25-(OH)2D3,FGF-23,iPTH in the two groups before treatment and 6 months after treatment were observed.Results After 6 months of treatment,CRP,Hb,Alb,TC,TG levels of the observation group improved significantly than before treatment and more significantly than those of the control group(P<0.05);the changes of serum BUN,Scr levels in two groups were not statistically significantly different(P>0.05).In the observation group,serum phosphorus,FGF-23 and iPTH were significantly decreased(P<0.05),the levels of 1,25-(OH)2D3 significantly increased(P<0.01).Conclusion Regular hemodialysis and hemoperfusion combined therapy for the patients with long-term hemodialysis can improve the micro inflammatory state,maintain the balance of the metabolism of calcium and phosphorus,and further improve the life quality and survival rate,which is worthy of clinical popularizing.