徐庆东, 郭焕开, 陈小荷, 姜松青, 石晓峰. 腹膜透析和血液透析对终末期肾脏疾病患者钙磷代谢及炎症因子的影响[J]. 临床肾脏病杂志, 2017, 17(4): 226-229. DOI: 10.3969/j.issn.1671-2390.2017.04.007
    引用本文: 徐庆东, 郭焕开, 陈小荷, 姜松青, 石晓峰. 腹膜透析和血液透析对终末期肾脏疾病患者钙磷代谢及炎症因子的影响[J]. 临床肾脏病杂志, 2017, 17(4): 226-229. DOI: 10.3969/j.issn.1671-2390.2017.04.007
    XU Qing-dong, GUO Huan-kai, CHEN Xiao-he, JIANG Song-qing, SHI Xiao-feng. Effects of different kinds of dialysis on calcium-phosphorus metabolism and inflammatory factors in patients with end-stage renal disease[J]. Journal of Clinical Nephrology, 2017, 17(4): 226-229. DOI: 10.3969/j.issn.1671-2390.2017.04.007
    Citation: XU Qing-dong, GUO Huan-kai, CHEN Xiao-he, JIANG Song-qing, SHI Xiao-feng. Effects of different kinds of dialysis on calcium-phosphorus metabolism and inflammatory factors in patients with end-stage renal disease[J]. Journal of Clinical Nephrology, 2017, 17(4): 226-229. DOI: 10.3969/j.issn.1671-2390.2017.04.007

    腹膜透析和血液透析对终末期肾脏疾病患者钙磷代谢及炎症因子的影响

    Effects of different kinds of dialysis on calcium-phosphorus metabolism and inflammatory factors in patients with end-stage renal disease

    • 摘要: 目的 探讨不同透析方式对终末期肾脏疾病患者钙磷代谢及炎症因子水平的影响。方法 选取2015年1月至2015年12月在江门市中心医院接受血液净化治疗的250例终末期肾脏疾病患者为研究对象,根据透析方式的不同分为2组,腹膜透析(peritoneal dialysis,PD)组115例,血液透析(hemodialysis,HD)组135例。对所有患者均进行至少6个月的随访调查,比较2组透析后炎症因子水平(C反应蛋白、白细胞介素6、肿瘤坏死因子α)、钙磷代谢水平(血钙、血磷)、生化指标水平(总胆固醇、三酰甘油、总蛋白、血红蛋白、白蛋白、血肌酐、尿素氮)、生存质量状况及并发症发生率。结果 PD组C反应蛋白水平较HD组低,差异有统计学意义(P<0.05);2组白细胞介素6、肿瘤坏死因子α、血钙及血磷比较差异无统计学意义(P>0.05)。PD组总蛋白、白蛋白水平较HD组低,差异有统计学意义(P<0.05);其余生化指标无统计学差异(P<0.05)。2组生存质量评估无统计学差异(P>0.05)。PD组感染、低蛋白血症发生率比HD组高,差异有统计学意义(P<0.05);PD组高血压、心律失常及充血性心力衰竭发生率较HD组低,差异有统计学意义(P<0.05)。结论 行PD或HD的终末期肾脏疾病患者体内均存在炎症反应,且HD患者炎症反应更为严重;两种透析方式对钙磷代谢的影响未见明显差异,临床应根据患者具体情况,选择合理的透析方式。

       

      Abstract: Objective To investigate the effects of different kinds of dialysis on calcium-phosphorus metabolism and inflammatory factors in patients with end-stage renal disease (ESRD).Methods 250 ESRD patients treated in our hospital from January 2015 to December 2015 were divided into two groups given different dialysis procedures: 115 cases given peritoneal dialysis (PD), and the rest 135 cases hemodialysis (HD). All the patients were given a 6-month follow-up investigation. The inflammatory factors (CRP, IL-6, TNF-α) levels, calcium-phosphorus metabolism levels (Ca, P), biochemical index levels total cholesterol (TC), triglyceride (TG), total protein (TP), hemoglobin (Hb), albumin (Alb), serum creatinine (SCr), and blood urea nitrogen (BUN), living quality and incidence of complications between two groups after treatment were compared.Results The C-reactive protein level in PD group was lower than that in HD group (P<0.05). There was no significant difference in IL-6, TNF-α, Ca and P levels between two groups (P>0.05). There was no significant difference in TC, TG, Hb, SCr and BUN between two groups (P>0.05). The TP and Alb in PD group were significantly lower than those in HD group (P<0.05). There was no significant difference in living quality between two groups (P>0.05). The incidence of infection and hypoproteinemia in PD group was significantly higher than that in HD group (P<0.05). The incidence of hypertension, arrhythmia and congestive heart failure in PD group was significantly lower than that in HD group (P<0.05).Conclusions ESRD patients with PD or HD have inflammatory response and patients with HD have more severe response. The effects of two kinds of dialysis on calcium-phosphorus metabolism have no significant difference. The suitable dialysis procedure should be selected in terms of patients' clinical specific conditions.

       

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