中国血液净化

中国血液净化 ›› 2024, Vol. 23 ›› Issue (06): 410-416.doi: 10.3969/j.issn.1671-4091.2024.06.003

• 临床研究 • 上一篇    下一篇

不同血液灌流治疗频率对维持性血液透析患者蛋白质能量消耗的影响

尹怡芳   牟 娇   杨 影   唐建英    

  1. 400715 重庆，1重庆医科大学附属大学城医院肾病泌尿中心
  • 收稿日期:2024-01-15 修回日期:2024-03-19 出版日期:2024-06-12 发布日期:2024-06-12
  • 通讯作者: 唐建英 E-mail:800273@hospital.cqmu.edu.cn

The Influence of Different Frequency of Hemoperfusion on Protein-energy Wasting of Maintenance Hemodialysis Patients 

The Influence of Different Frequency of Hemoperfusion on Protein-energy Wasting of Maintenance Hemodialysis Patients    

  1. Department of Nephrology and Urology Center,University Town Hospital Affiliated to Chongqing Medical University, Chongqing 400715,China
  • Received:2024-01-15 Revised:2024-03-19 Online:2024-06-12 Published:2024-06-12
  • Contact: 400715 重庆，1重庆医科大学附属大学城医院肾病泌尿中心 E-mail:800273@hospital.cqmu.edu.cn

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摘要： 的 探究不同血液灌流(hemoperfusion,HP)频率对维持性血液透析(maintenance hemodialysis,MHD)患者蛋白质能量消耗(protein-energy wasting,PEW)的影响。 方法 共纳入80例患者，根据HP治疗频率分为无HP(A)组、每月1次HP组(B)组、每半月1次HP(C)组、每周1次HP(D)组，每组20例患者，随访半年。比较4组患者治疗前后PEW患病率、营养不良炎症评分(malnutrition-inflammation score,MIS)及相关生化指标。 结果 治疗前，4组患者MIS评分(F=2.194，P=0.096)、PEW患病率(χ2=0.579，P=0.901)、前白蛋白(PA)(F=0.258，P=0.855)、白蛋白(Alb)(F=0.187，P=0.905)、甲状旁腺激素(PTH)(F=0.780，P=0.509)、血红蛋白(Hb)(F=1.823，P=0.150)、β2-微球蛋白(β2-MG)(F=1.833，       P=0.148)、C反应蛋白(CRP)(F=0.432，P=0.731)水平比较均无统计学差异；治疗后，D组有15例患者退出试验，C组MIS评分(C-A：t=4.391,P≤0.001；C-B：t=-2.871,P=0.006)、PTH(C-A：t=4.098,P=0.001；C-B： t=-2.551,P=0.047)、β2-MG(C-A：t=5.688,P＜0.001；C-B：t=-3.207,P=0.002)、CRP(C-A：t=4.293,   P＜0.001；C-B：t=-2.843,P=0.006)水平低于A、B组；C组PA(C-A：t=-3.177,P=0.002；C-B：t=2.196,    P=0.032)、Alb(C-A：t=-5.540,P＜0.001；C-B：t=2.196,P=0.010)水平高于A、B组；C组Hb(t=-3.733,P＜0.001)水平高于A组，与B组比较无统计学差异(t=1.451,P=0.152)；C组PEW患病率(χ2=6.465,P=0.011)低于A组，A、B 2组间PEW患病率无统计学差异(χ2=2.506，P=0.113)。 结论 半月1次的HP治疗可以明显改善MHD患者的营养状况，降低PEW的患病率。 
【关键词】维持性血液透析；蛋白质能量消耗；血液灌流；尿毒症毒素

关键词: 维持性血液透析, 蛋白质能量消耗, 血液灌流, 尿毒症毒素

Abstract: The Influence of Different Frequency of Hemoperfusion on Protein-energy Wasting of Maintenance Hemodialysis Patients   YIN Yi-fang1,MOU Jiao1,YANG Ying1,TANG Jian-ying1    1Department of Nephrology and Urology Center,University Town Hospital Affiliated to Chongqing Medical University, Chongqing 400715,China
Corresponding author: TANG Jian-ying, Email:800273@hospital.cqmu.edu.cn
【Abstract】Objective  To investigate the impact of different hemoperfusion (HP) frequencies on protein-energy wasting (PEW) in patients undergoing maintenance hemodialysis (MHD).  Methods Eighty patients were included and divided based on HP treatment frequency into four groups: no HP (group A), monthly HP (group B), bi-monthly HP (group C) and weekly HP (group D) , with 20 patients in each group. All patients were followed up for six months, then the prevalence of PEW, malnutrition-inflammation score (MIS), and related serum biochemical indicators were analyzed before and after treatment.   Results   Before treatment, there were no significant differences (P＞0.05) in MIS scores (F=2.194, P=0.096),  the prevalence of PEW (χ2=0.579, P=0.901), level of pre-albumin (PA) (F=0.258, P=0.855), albumin (Alb) (F=0.187, P=0.905), parathyroid hormone (PTH) (F=0.780, P=0.509), hemoglobin(Hb)(F=1.823，P=0.150), β2-microglobulin (β2-MG) (F=1.833, P=0.148), and C-Reactive protein (CRP) (F=0.432, P=0.731) among the four groups. After treatment, there were 15 patients who withdrew from the trial in Group D. The group C had lower levels of MIS score (C-A: t=4.391, P＜0.001;  C-B: t=-2.871,  P=0.006),  PTH (C-A: t=4.098, P=0.001; C-B: t=-2.551,     P=0.047),β2-MG (C-A: t=5.688, P＜0.001; C-B: t=-3.207, P=0.002), CRP (C-A:t=4.293, P＜0.001; C-B:     t=-2.843, P=0.006) compared with group A and B); and higher level of PA(C-A: t=-3.177, P=0.002; C-B:      t=2.196, P=0.032). Alb (C-A: t=-5.540, P＜0.001; C-B: t=2.196, P=0.010) than Groups A and B. Group C had higher level of Hb (t=-3.733, P＜0.001) than group A, and  no significant difference with group B (t=1.451,  P=0.152). The prevalence of PEW in group C (χ2=6.465, P=0.011) was significantly lower than group A, but there was no significant difference between group A and group B (χ2=2.506, P=0.113).  Conclusion   Bimonthly HP treatment can obviously improve the nutritional status of patients with MHD and reduce the prevalence of PEW.

Key words: Maintenance hemodialysis, Protein-energy wasting, Hemoperfusion, Uremic toxins

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