中国血液净化

中国血液净化 ›› 2021, Vol. 20 ›› Issue (09): 637-639.doi: 10.3969/j.issn.1671-4091.2021.09.016

• 护理研究 • 上一篇    下一篇

血液滤过吸附的临床应用效果观察

李梦婷1,杨诗瑾1,张留平1,王越1,谢庆磊1   

  1. 1东南大学附属中大医院血液净化中心
  • 收稿日期:2021-03-30 修回日期:2021-05-26 出版日期:2021-09-12 发布日期:2021-09-12
  • 通讯作者: 张留平 shery9926@sina.com E-mail:shery9926@sina.com
  • 基金资助:
    江苏现代医院管理研究中心2019年立项课题，(JSY-2-2019-09)

Observation of clinical efficacy of hemofiltration adsorption

  1.  1Blood Purification Center, Zhongda Hospital Affiliated to Southeast University, Nanjing 210009, China
  • Received:2021-03-30 Revised:2021-05-26 Online:2021-09-12 Published:2021-09-12

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摘要： 【摘要】目的观察血液滤过吸附(hemodiafiltration with endogenous reinfusion,HFR)应用于维持性血液透析患者中的效果。方法收集东南大学附属中大医院血液净化中心符合纳排标准的维持性血液透析患者20 例，于4 周的血液透析(hemodialysis，HD)治疗洗脱期后，按每周3 次分别为HD-HFRHD的治疗模式，持续4 周，观察患者HFR 治疗前后血压、β2-微球蛋白、C 反应蛋白及炎症因子变化情况，HFR 治疗与HD 治疗透析充分性、疲劳感方面的差异。结果HFR 治疗前后患者血压平稳，未出现大幅度波动，β2-微球蛋白(t= 1.557,P=0.040)下降显著，C 反应蛋白(t=0.152,P=0.945)及白细胞介素- 2(t=0.074,P=0.866)、白介素-6(t=0.392,P=0.619)、肿瘤坏死因子-α(t=2.042,P=0.068)等促炎因子也有一定程度的下降。HFR 与常规HD 治疗相比，患者的尿素下降率(URR)无明显变化(t= 0.815，P=0.431)，但患者行HFR 治疗期间的疲劳评分低于患者HD 治疗(t=3.834,P=0.001)。结论HFR 与传统HD 治疗模式相比，在透析充分性方面没有差异，HFR 具有可有效降低患者体内微炎症状态的特性。

关键词: 血液吸附滤过, 血液透析, 临床应用

Abstract: 【Abstract】Objective To observe the efficacy of hemodiafiltration with endogenous reinfusion (HFR) in maintenance hemodialysis (MHD) patients. Methods A total of 20 MHD patients were collected from Blood Purification Center, Zhongda Hospital Affiliated to Southeast University. After hemodialysis (HD) treatment for 4 weeks as the washout period, they were treated with the HD-HFR-HD mode as the three times of dialysis in a week for 4 weeks. Blood pressure, β2-microglobulin, C-reactive protein and inflammatory cytokines were examined before and after the HFR treatment. Dialysis adequacy and fatigue were observed in the HD and HFR treatment periods. Results Blood pressure was stable before and after HFR treatment. β2-microglobulin (t=1.557, P=0.040) decreased significantly. C-reactive protein (t=0.152, P=0.945), interleukin-2 (t=0.074, P=0.866), interleukin-6 (t=0.392, P=0.619), tumor necrosis factor-α (t=2.042, P=0.068) were also reduced but without statistical significance. After HFR, dialysis adequacy had no significant change (t=0.815, P=0.431), but fatigue score decreased significantly (t=3.834, P=0.001) as compared with those after HD. Conclusion Compared with HD, HFR significantly alleviates the microinflammatory status of the patients but without difference in dialysis adequacy.

Key words: Hemodiafiltration with endogenous reinfusion, Hemodialysis, Clinic application

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