不同通量血液透析联合血液透析滤过对胰岛素抵抗尿毒症患者的疗效比较

目的 对比不同通量血液透析联合血液透析滤过对胰岛素抵抗尿毒症患者的疗效.方法 选取江门市人民医院2019年5月至2020年8月60例胰岛素抵抗尿毒症患者作为研究对象,随机分为两组,每组30例,分别采用低通量血液透析联合血液透析滤过(LFHD+HDF)和高通量血液透析联合血液透析滤过(HFHD+HDF)干预,对比两组患者...

Comparison of the curative effect of different flux hemodialysis combined with hemodiafiltration on patients with insulin resistance uremia

ObjectiveTo compare the effects of different fluxes of hemodialysis combined with hemodiafiltration on insulin-resistant uremia patients. MethodsA total of 60 insulin-resistant uremia patients from Jiangmen People's Hospital from May 2019 to August 2020 were selected as the research subjects. They were randomly divided into two groups, 30 cases in each group, and they were treated with low-flux hemodialysis combined with hemodiafiltration. (LFHD+HDF) and high flux hemodialysis combined with hemodiafiltration (HFHD+HDF) intervention. The fasting blood glucose (FPG), fasting plasma insulin (FINS), insulin resistance index (HOMA-IR) before treatment and 3 months and 6 months after treatment were compared between the two groups, as well as their cholesterol (TC) and triacyl Glycerin (TG), serum albumin (ALB), blood urea nitrogen (BUN), creatinine (SCr), β2-microglobulin (β2-MG), parathyroid hormone (PTH), hypersensitive C-reactive protein (Hs) -CRP) and other related indicators. ResultsThe FINS and HOMA-IR levels of the HFHD+HDF group after 3 and 6 months of treatment were lower than those of the LFHD+HDF group (P<0.05). And the levels of TC, TG, PTH and Hs-CRP in the HFHD+HDF group after 3 and 6 months of treatment were significantly lower than those in the LFHD+HDF group, the difference was statistically significant (P<0.05); the HFHD+HDF group was The levels of TC, TG, PTH and Hs-CRP after 3 and 6 months of treatment were significantly lower than those of the LFHD+HDF group (P<0.05), and the Kt/V levels of the LFHD+HDF group were significantly lower than the treatment for 6 months Before, the Kt/V level of the HFHD+HDF group was significantly higher than that before treatment, and was significantly higher than that of the LFHD+HDF group, the difference was statistically significant (P<0.05). ConclusionsHigh-flux hemodialysis combined with hemodiafiltration (HFHD+HDF) compared with low-flux hemodialysis combined with hemodiafiltration (LFHD+HDF) can improve insulin resistance and body lipid metabolism in patients with insulin resistance uremia, and improve renal function.