【摘要】 目的:分析维持性血液透析(Maintenance Hemodialysis, MHD)合并血液灌流(Hemoperfusion, HP)对尿毒症合并高血压患者毒素清除作用及神经内分泌激素的影响。方法:选取我院2018年6月至2020年6月收治合并高血压的尿毒症患者92例，采用数字随机表法将其分为对照组(MHD组，n=46)和观察组(HP+MHD组，n=46),收集患者的临床资料，比较两组患者治疗前后体内毒素水平因子C反应蛋白(CRP)、同型半胱氨酸(Hcy)、大分子毒素(β2-MG)、马尿酸(HA)、甲状旁腺激素(PTH)水平的变化，神经内分泌激素血管紧张素Ⅱ(AngⅡ)、肾素(PRA)、醛固酮(Ald)水平的变化，以及两组不良反应的发生情况。结果:两组患者治疗前体内毒素水平因子对比(P>0.05),经过治疗后，观察组患者体内CRP、Hcy、β2-MG、HA、PTH水平较治疗前均有所降低、对照组患者β2-MG水平降低，CRP、Hcy、HA、PTH却较治疗前有所上升，观察组治疗后内毒素水平与对照组对比(P<0.05),观察组患者治疗后神经内分泌激素AngⅡ、PRA、Ald改善效果与对照组比较差异明显(P<0.05),观察组患者的不良反应明显低于对照组(P<0.05)。结论:维持性血液透析联合血液灌流治疗伴有高血压的尿毒症患者，可以有效清除患者体内毒素，降低神经内分泌激素的分泌，临床疗效显著。更多还原

【Abstract】 Objective: To analyze the effects of maintenance hemodialysis(MHD) combined with hemoperfusion(HP) on toxin clearance and neuroendocrine hormones in patients with uremia and hypertension. Methods: A total of 92 uremic patients with hypertension who were admitted to our hospital from June 2018 to June 2020 were selected and divided into the control group(MHD group, n=46) and the observation group(HP+MHD group, n=46) by random table method. Clinical data of patients were collected to compare the changes in the levels of toxin level factors C-reactive protein(CRP), homocysteine(Hcy), macronutrient toxin(β2-MG), horse uric acid(HA), parathyroid hormone(PTH) levels, changes in the levels of neuroendocrine hormones angiotensin Ⅱ(Ang Ⅱ), renin(PRA), aldosterone(Ald), and the occurrence of adverse reactions in both groups before and after treatment.Results: After treatment, the levels of CRP, Hcy, β2-MG, HA and PTH in patients of the observation group decreased compared with those before treatment, while the levels of β2-MG in patients of the control group decreased, but the levels of CRP, Hcy, HA and PTH increased compared with those before treatment, and the levels of endotoxin in the observation group after treatment were compared with those in the control group(P<0.05), the improvement effect of neuroendocrine hormones Ang Ⅱ, PRA and Ald in the observation group patients after treatment was significantly different compared with the control group(P<0.05), and the adverse reactions in the observation group patients were significantly lower than those in the control group(P<0.05).Conclusion: Maintenance hemodialysis combined with hemoperfusion in the treatment of uremic patients with hypertension can effectively remove toxins from the patient’s body and reduce the secretion of neuroendocrine hormones, and the clinical effect is significant.更多还原