不同血液净化方式透析效果及对营养状态的影响

目的探讨不同血液净化方式的透析效果及对长期血液透析患者营养状态的影响。方法将20例晚期肾病患者,随机分为2组:HD组应用标准血液透析治疗;HDF/HD组采用2次血液透析+1次血液透析滤过(HDF)。比较两组患者治疗前后血清尿素、磷、β2-MG、血浆白蛋白(Alb)、前白蛋白(PA)、转铁蛋白(TF)、血红蛋白(Hb)、平均动脉压、Bun及Cr的变化,以及患者对治疗的耐受性。分别计算KT/v及PCR值。结果经过血液透析滤过治疗5个月,患者精神好转、食欲增加、体力恢复、自理能力增强。HDF/HD组与HD组比较,血清磷、β2-MG、KT/v明显降低,血浆白蛋白、前白蛋白、转铁蛋白和血红蛋白均明显升高;PCR值两组之间无明显差异。结论HDF治疗效果好,能明显改善患者的透析充分性和营养状态,是值得向长期维持性血透患者推荐的透析方式之一。

The clinical study on dialysis effect and nutritional status of different dialysis modes

Objective To evaluate the clinical dialysis effect and nutritional status of hemodiafiltration and the tolerance of patients to treatment.Methods 20 patients with maintenance hemodialysis were randomly divided into two groups: HD group and HDF group.Serum Bun,Cr,P,β_(2)-MG level,blood gas and plasma albumin,transfer ion protein,pre-albumin and hemoglobin were examined 5 months before and after hemodiafiltration.The values of KT/v and PCR were calculated.Results No significant difference was found in the clearances of Cr,Bun and PCR value between HDF and HD groups;But β_(2)-MG,P in serum and the value of KT/v were significantly decreased in HDF;The albumin, transfer ion protein,pre-albumin and hemoglobin were elevated in HDF;HDF had better effect on the patients with maintenance hemodialysis.Conclusion Hemodiafiltration is a better dialysis mode for patients with maintenance hemodialysis.