中国血液净化

中国血液净化 ›› 2020, Vol. 19 ›› Issue (12): 824-828.doi: 10.3969/j.issn.1671-4091.2020.12.008

• 临床研究 • 上一篇    下一篇

高通量血液透析对比低通量血液透析临床效果Meta 分析

蒋宇豪1,王耀羚2,郭武栋2,赵琨2,王世宇1   

  1. 1成都中医药大学
    2国家卫生健康委卫生发展研究中心
  • 收稿日期:2020-07-21 修回日期:2020-09-14 出版日期:2020-12-12 发布日期:2020-12-08
  • 通讯作者: 王世宇 497217505@qq.com E-mail:497217505@qq.com

Clinical effect of high flux hemodialysis versus low flux hemodialysis: a meta analysis

  1. 1Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China;  2China National Health Development Research Center, Beijing 100044,China
  • Received:2020-07-21 Revised:2020-09-14 Online:2020-12-12 Published:2020-12-08

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摘要： [摘要]目的采用荟萃(Meta)分析评价和比较高通量血液透析(high flux hemodialysis,HFHD)与低通量血液透析(low flux hemodialysis, LFHD)对于终末期肾病(end-stage renal disease,ESRD)患者的效果。方法系统检索中国知网、万方、PubMed、Cochrane library、Embase 等数据库中有关HFHD 与LFHD 治疗ESRD 患者的随机对照试验(randomized controlled trials,RCT)、准RCT 等研究文献，采用RevMan5.3 统计软件进行Meta 分析。结果最终纳入22项研究，共7590 例患者。Meta 分析结果显示HFHD 全因死亡率(RR=0.766, 95% CI 0.659～0.890,P＜0.001)低于LFHD。与LFHD组比较，HFHD组患者在心血管疾病死亡率、β2-微球蛋白(beta-2 microglobulin, β2-MG)清除、总胆固醇和三酰甘油水平、炎症反应指标上均显示出了相对较好的效果(RR/MD/SMD 值分别为0.792,- 10.235,- 0.244, - 0.248,-0.225；95% CI 分别为0.696～0.901,- 12.475～- 7.994,- 0.446～- 0.041,- 0.406～- 0.090,- 0.340～-0.110；P 值分别为＜0.001,＜0.001,0.020,0.002,＜0.001)。结论HFHD 较LFHD 其死亡率和心血管疾病死亡率低，拥有良好的β2-MG、血脂、炎症因子等清除效果，对ESRD 患者能带来较大的疗效获益。

关键词: 高通量血液透析, 低通量血液透析, 终末期肾病, 死亡率, Meta 分析

Abstract: 【Abstract】Objective To assess the effect of high flux hemodialysis (HFHD) and low flux heamodialysis (LFHD) on end-stage renal disease (ESRD) patients by Meta analysis. Methods The randomized controlled trails (RCTs) and quasi-RCTs which compared HFHD with LFHD in ESRD patients were searched in the PubMed, Embase, Cochrane Library, CNKI and Wanfang electronic databases. RevMan5.3 was used for meta analysis. Results A total of 22 studies were included that involved 7,590 participants with ESRD. Meta analysis results showed that all-cause mortality was lower in the participants using HFHD than in those using LFHD (RR= 0.766, 95% CI: 0.659～0.890, P<0.001). Compared with the LFHD group, the HFHD group showed better outcomes in cardiovascular mortality (RR=0.792, 95% CI: 0.696～0.901, P<0.001), beta-2 microglobulin (MD=-10.235, 95% CI: -12.475～ -7.994, P<0.001), lipid profiles (total cholesterol: MD=-0.244, 95% CI: -0.446～- 0.041, P=0.020; triglycerides: MD=- 0.248, 95% CI: - 0.406～- 0.090, P=0.002) and inflammation markers (SMD=-0.225, 95% CI: -0.340～-0.110, P<0.001). Conclusion Compared the patients using LFHD, ESRD patients using HFHD had lower mortality and cardiovascular mortality with better clearance effects for lipids, middle molecular substances and inflammation factors, bringing more benefits to ESRD patients.

Key words: High flux hemodialysis, Low flux hemodialysis, End- stage renal disease, Mortality, Meta analysis

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