高通量血液透析对糖尿病肾病患者生存率的影响研究

目的观察高通量血液透析对糖尿病肾病患者生存率的影响。方法选取定安人民医院2014年4月-2015年4月收治的糖尿病肾病患者80例,按透析通量将其分为高通量组和低通量组,各40例,两组患者均实施常规治疗,其中低通量组给予低通量血液透析,高通量组给予高通量血液透析,两组透析频次:4 h/次,3次/周,透析时间:6个月。两组患者透析半年后观察透析效果,包括:肾功能指标血尿素氮(BUN)、血清肌酐(Scr)]、糖代谢指标空腹血糖(FPG)、餐后2 h血糖(2hFPG)]及炎症指标血β2-微球蛋白(β2-MG)、超敏C反应蛋白(hs-CRP)],并对两组患者实施为期3年随访调查,观察1年、3年生存率。结果透析半年后,高通量组BUN、FPG、2hFPG、β2-MG、hs-CRP水平均低于低通量组,Scr水平高于低通量组(P<0.05)。透析1年,高通量组和低通量组生存率间差异无统计学意义(P>0.05);透析3年,高通量组生存率72.50%,高于低通量组50.00%,差异有统计学意义(P<0.05)。结论糖尿病肾病患者采用高通量血液透析能提高血液透析效果,改善患者肾功能,同时提高3年生存率。

Effects of High-flux Hemodialysis on Survival of Patients with Diabetic Nephropathy

Objective To observe the 1-year and 3-year survival rates of high-flux hemodialysis in patients with diabetic nephropathy.Methods Eighty patients with diabetic nephropathy admitted to our hospital between April 2014 and April 2015 were enrolled.According to the dialysis flux,these patients were divided into the high-flux group and low-flux group,with 40 cases in each group.The two groups were given routine treatment,but the low-flux group was given low-flux hemodialysis,while the high-flux group was given high-flux hemodialysis.The dialysis frequency of the two groups was 4 h/time,3 times/wk,and dialysis lasted 6 months.The dialysis effects were observed after six-month dialysis in the two groups,involving renal function indicators〔blood urea nitrogen(BUN),serum creatinine(Scr)〕,glucose metabolism indexes〔fasting plasma glucose(FPG),2-hour fasting plasma glucose(2hFPG)〕and inflammatory markers〔β2-microglobulin(β2-MG),and hypersensitive C-reactive protein(hs)-CRP)〕.A three-year follow-up survey was performed on the two groups,and the 1-year and 3-year survival rates were observed.Results After six months of dialysis,the BUN,FPG,2hFPG,β2-MG and hs-CRP levels in the high-flux group were lower than those in the low-flux group,but the Scr level was higher than that in the low-flux group(P<0.05).After one year of dialysis,the survival rates in the two groups were comparable(P>0.05).After three years of dialysis,the survival rate in the high-flux group was higher than that in the low-flux group(72.50%vs 50.00%)(P<0.05).Conclusion High-flux hemodialysis for patients with diabetic nephropathy can improve hemodialysis effects and renal function,and enhance the three-year survival rate.