【摘要】 目的:探讨血液灌流联合血液透析与血液透析滤过治疗对维持性血液透析(MHD)患者矿物质及骨代谢状况的影响。方法:选取2017年1月至2019年9月本院行MHD治疗患者90例,按照随机数字表法分为两组,各45例。观察组给予血液灌流联合血液透析治疗,对照组给予血液透析滤过治疗,连续治疗6个月。所有患者均在接受治疗方案前及治疗6个月后分析肾功能、矿物质以及骨代谢状况,观察两组治疗过程中临床症状改善情况。结果:治疗后,两组患者血清血肌酐(Scr)、尿素氮(BUN)和β2-微球蛋白(β2-MG)水平均明显降低,且观察组低于对照组(P<0.05)。治疗后,观察组中皮肤瘙痒、关节疼痛、肌无力和高血压等症状发生率显著低于对照组(P<0.05)。治疗后,两组血钙水平与治疗前相比无明显改变(P>0.05),而观察组血磷水平显著低于对照组(P<0.05)。两组治疗后血清骨保护素(OPG)、骨形态发生蛋白-2(BMP-2)及骨碱性磷酸酶(BALP)水平明显降低,且观察组低于对照组(P<0.05)。结论:血液灌流联合血液透析有效改善MHD患者临床症状,纠正矿物质及骨代谢异常。更多还原

【Abstract】 Objective: To investigate the effect of hemoperfusion combined with hemodialysis and hemodiafiltration on mineral and bone metabolism in patients with maintenance hemodialysis. Methods: A total of90 cases of MHD patients were selected from January 2017 to September 2019. Those patients were divided into two groups with 45 cases each according to the random number table method. The observation group was treated with hemoperfusion combined with hemodialysis,while the control group was treated with hemodiafiltration. The treatment lasted for 6 months. The renal function,mineral and bone metabolism of the two groups were compared before and 6 months after treatment,and the clinical symptoms of the two groups were observed. Results: After treatment,the levels of serum creatinine( Scr),blood urea nitrogen( BUN) and β2-MG were significantly reduced in both groups,and the levels of those indexes in the observation group were lower than those in the control group( P <0.05). After treatment,the incidences of skin pruritus,joint pain,muscle weakness and hypertension in the observation group were significantly lower than those in the control group( P <0.05). After treatment,there was no significant change in blood calcium level in the two groups compared with before treatment( P >0.05),while the blood phosphorus level in the observation group was significantly lower than that in the control group( P <0.05). The serum levels of osteoprotegerin( OPG),Bone morphogenetic protein-2( BMP-2) and bone alkaline phosphatase( BALP) in the two groups were significantly reduced,and the observation group was lower than the control group after treatment( P <0.05). Conclusion: Hemoperfusion combined with hemodialysis can effectively improve the clinical symptoms of MHD patients and correct abnormal mineral and bone metabolism.更多还原