血液透析与连续性血液净化透析治疗急性肾衰竭的疗效及对患者毒素清除率和肾功能指标的影响

doi:10.3969/j.issn.1006-6233.2020.05.021

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摘要 目的:探讨间歇性血液透析(IHD)与连续性血液净化透析(CBP)治疗急性肾衰竭(ARF)的疗效及对患者毒素清除率和肾功能指标的影响。方法:96例ARF患者随机分为CBP组(接受CBP治疗,48例)和IHD组(接受IHD治疗,48例),比较两组血气指标、肾功能指标、毒素清除率、治疗恢复情况及并发症发生率。结果:两组治疗后心率、收缩压(SBP)、舒张压(DBP)显著降低(P<0.05),血氧饱和度(SpO₂)显著升高(P<0.05),组间比较无显著差异(P>0.05);两组治疗后尿素氮(BUN)、血肌酐(Scr)、血磷、血尿酸、β2-微球蛋白(β2-MG)水平均显著降低(P<0.05),但CBP组降低幅度大于IHD组(P<0.05);CBP组BUN、Scr、血磷、血尿酸、β2-MG清除率显著高于IHD组(P<0.05);CBP组治疗时间短于IHD组(P<0.05),两组治疗后急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分均显著降低,但CBP组降低幅度大于IHD组(P<0.05);CBP组并发症发生率显著低于IHD组(P<0.05)。结论:CBP能有效提高ARF患者的透析效果,提高毒素清除率,促进肾功能恢复,减少并发症。

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关键词 ：连续性血液净化透析, 肾功能, 毒素清除率, 急性肾衰竭

Abstract：Objective: To explore the efficacy of intermittent hemodialysis (IHD) and continuous blood purification dialysis (CBP) in the treatment of acute renal failure (ARF) and its influence on toxin clearance rate and renal function indexes. Methods: 96 patients with ARF were randomly divided into CBP group (given CBP therapy, 48 cases) and IHD group (given IHD therapy, 48 cases). Blood gas indexes, renal function indexes, toxin clearance rate, treatment recovery and incidence rate of complications were compared between the two groups. Results: After treatment, the heart rate, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly deScreased in the two groups (P<0.05) while the blood oxygen saturation (SpO₂) was significantly inScreased (P<0.05), and there were no significant differences between the two groups (P>0.05). After treatment, the levels of urea nitrogen (BUN), Screatinine (Scr), blood phosphorus, blood uric acid and β2-miScroglobulin (β2-MG) were significantly deScreased in the two groups (P<0.05), but the deScreases in CBP group were greater than those in IHD group (P<0.05). The clearance rates of BUN, Scr, blood phosphorus, blood uric acid and β2-MG in CBP group were significantly higher than those in IHD group (P<0.05). The treatment time in CBP group was shorter than that in IHD group (P<0.05). The acute physiology and chronic health evaluation II (APACHE II) scores in the two groups were significantly deScreased after treatment, and the reduction in CBP group was greater than that in IHD group (P<0.05). The incidence rate of complications in CBP group was significantly lower than that in IHD group (P<0.05). Conclusion: CBP can effectively improve the dialysis effects of ARF patients, enhance the toxin clearance rate, promote the recovery of renal function and reduce complications.

Key words： Continuous blood purification dialysis Renal function Acute renal failure Toxin clearance rate

基金资助:海南省医药卫生科研项目,(编号:140400032A2004)

通讯作者: 蒙绪君

引用本文:

王克坤, 蒙绪君, 韩辉, 何华妮, 林子艳, 王捷. 血液透析与连续性血液净化透析治疗急性肾衰竭的疗效及对患者毒素清除率和肾功能指标的影响[J]. 河北医学, 2020, 26(5): 788-792.
WANG Kekun, et al. Efficacy of Hemodialysis and Continuous Blood Purification Dialysis on Acute Renal Failure and its Influence on Toxin Clearance Rate and Renal Function Indexes. HeBei Med, 2020, 26(5): 788-792.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2020.05.021 或 http://www.hbyxzzs.cn/CN/Y2020/V26/I5/788

[1] Zattera T , Londrino F , Trezzi M , et al. Pemetrexed-induced acute kidney failure following irreversible renal damage: Two case reports and literature review[J].Nephropathol, 2017, 6(2):43~48.
[2] Vakrani G P , Subramanyam N T . Acute renal failure in dengue infection[J].Clin Diagn Res, 2017, 11(1):OC10~OC13.
[3] Szalat A , Perlman A , Muszkat M , et al. Can SGLT2 inhibitors cause acute renal failure plausible role for altered glomerular hemodynamics and medullary hypoxia[J]. Drug Safety, 2017,41(3):239~252.
[4] Attarian S , Yu C , Anderson K E , et al. Effects of hemin and hemodialysis in a patient with acute intermittent porphyria and renal failure[J]. Blood Adv, 2017, 1(14):915~917.
[5] 不同连续性血液净化介入时机对老年多脏器衰竭合并急性肾损伤预后的影响[J].中国医药导报,2017,14(2):106~109,113.
[6] Koza Y. Acute kidney injury: Current concepts and new insights[J].Inj Violence Res, 2016, 8(1):58~62.
[7] 薛茫.连续性肾脏替代疗法对重症急性肾衰竭患者微炎症状态及肾功能影响的临床观察[J].临床肾脏病杂志,2017,17(12):744~747.
[8] Vandana P , Pooja S , Sundaram G , et al. Hypercalcemia, multiple osteolytic lesions, and acute renal failure: a rare presentation of B-cell acute lymphoblastic leukemia[J]. Blood Research, 2017, 52(1):65~67.
[9] Perlman A , Heyman S N , Matok I , et al. Acute renal failure with sodium-glucose-cotransporter-2 inhibitors: analysis of the FDA adverse event report system database[J]. Nutrition, Metabolism and Cardiovascular Diseases, 2017,27(12):1108~1113.
[10] Sebastian S , Frederic Z C , Dominik B , et al. Reduction of low molecular weight proteins under continuous renal replacement therapy in acute renal failure[J]. Clinical and Experimental Nephrology, 2018,23(3):429~430.
[11] 郭小芳.持续血液净化在脓毒症急性肾衰竭患者中的临床应用[J].医学临床研究,2017,34(3):577~579.