孙京华, 史灵芝, 刘秉诚, 李胜开, 蒋甘孺, 尹忠诚. 40例长期行血液透析滤过治疗的终末期肾病患者生存质量分析[J]. 临床肾脏病杂志, 2017, 17(12): 735-739. DOI: 10.3969/j.issn.1671-2390.2017.12.006
    引用本文: 孙京华, 史灵芝, 刘秉诚, 李胜开, 蒋甘孺, 尹忠诚. 40例长期行血液透析滤过治疗的终末期肾病患者生存质量分析[J]. 临床肾脏病杂志, 2017, 17(12): 735-739. DOI: 10.3969/j.issn.1671-2390.2017.12.006
    SUN Jing-hua, SHI Ling-zhi, LIU Bing-cheng, LI Sheng-kai, JIANG Gan-ru, YIN Zhong-cheng. Quality of life of 40 patients with end-stage renal disease treated by long-term hemodiafiltration[J]. Journal of Clinical Nephrology, 2017, 17(12): 735-739. DOI: 10.3969/j.issn.1671-2390.2017.12.006
    Citation: SUN Jing-hua, SHI Ling-zhi, LIU Bing-cheng, LI Sheng-kai, JIANG Gan-ru, YIN Zhong-cheng. Quality of life of 40 patients with end-stage renal disease treated by long-term hemodiafiltration[J]. Journal of Clinical Nephrology, 2017, 17(12): 735-739. DOI: 10.3969/j.issn.1671-2390.2017.12.006

    40例长期行血液透析滤过治疗的终末期肾病患者生存质量分析

    Quality of life of 40 patients with end-stage renal disease treated by long-term hemodiafiltration

    • 摘要: 目的 探讨长期血液透析滤过治疗患者的生存质量。方法 对40例血液透析滤过治疗6个月以上的终末期肾病患者进行横断面临床研究,研究项目包括血压、血红蛋白、钙磷代谢、甲状旁腺功能、营养状况、1年内住院次数及心血管事件等。结果 在40例患者中,血压控制在正常范围的患者17例(占42.5%);1级高血压的患者14例(占35%),收缩压<160 mmHg的患者占77.5%。血红蛋白(hemoglobin,Hb)平均水平(100.9±17.1) g/L,其中Hb≥90 g/L的患者31例(占77.5%),Hb≥110 g/L的患者12例(占30%)。血钙平均水平(2.37±0.32) mmol/L,其中2.1~2.5 mmol/L的患者16例(占40%),>2.5 mmol/L的患者16例(占40%);血磷平均水平(1.70±0.50) mmol/L,其中1.13~1.78 mmol/L的患者15例(占37.5%),>1.78 mmol/L的患者18例(占45%);钙磷乘积平均(48.6±16.6),其中<55的患者27例;全段甲状旁腺素(intact parathyroid hormone,iPTH)平均水平(500.9±548.1) ng/L,其中150~300 ng/L的患者5例(占12.5%),>300 ng/L的患者20例(占50%);血清总蛋白(total protein,TP)平均(71.4±6.6) g/L,白蛋白(albumin,Alb)平均(41.6±3.7) g/L。老年患者和非老年患者、糖尿病和非糖尿病患者在Hb、Ca、P、iPTH、TP、Alb等方面无统计学差异(均P>0.05)。1年内平均心血管事件发生率153.1/1000病人年,1年内平均住院率612.2/1000病人年。结论 终末期肾病患者通过长期血液透析滤过治疗,营养状况良好,血压及Hb达标率较高,但存在严重高钙血症、高磷血症及甲状旁腺功能亢进,同时血液透析滤过对老年患者、糖尿病患者可能更有益处。

       

      Abstract: Objective To explore the quality of life of patients treated with long-term hemodiafiltration. Methods A cross-sectional study was performed on 42 patients with end-stage renal disease who underwent hemodiafiltration for more than 6 months. Blood pressure, hemoglobin, calcium and phosphorus metabolism, parathyroid function, nutritional status, one-yearhospitalization and cardiovascular events were examined in these patients. Results Among the 40 patients, 17 patients (42.5%) had normal blood pressure, 14 patients (35%) had grade 1 hypertension, and systolic blood pressure in 77.5% of patients was <160 mmHg. The mean hemoglobin (Hb) level was (100.9±17.1) g/L, and Hb in 31 patients (77.5%) was ≥ 90 g/L, and that in 12 patients (30%) ≥ 110 g/L. The mean serum calcium (Ca) was (2.37±0.32) mmol/L, and Ca in 16 patients(40%) was 2.1~2.5 mmol/L, and Ca in 16 patients(40%) >2.5 mmol/L. The mean phosphate (P) was(1.70±0.50) mmol/L, and P in 15 patients (37.5%) was 1.13~1.78 mmol/L, and P in 18 patients (45%) >1.78 mmol/L. The mean Ca×P was (48.6±16.6), and Ca×P product in 27 patients was<55. The mean parathyroid hormone (PTH) was (500.9±548.1) ng/L, and iPTH in 5 cases (12.5%) was 150~300 ng/L, and iPTH in 20 cases (50%) >300 ng/L. The mean total protein was (71.4±6.6) g/L, and albumin was (41.6±3.7) g/L. There were no significant differences in levels of Hb, Ca, P, PTH, TP and Alb between elderly patients and non-elderly patients, nor between diabetic patients and non-diabetic patients (P>0.05 for all). One-year cardiovascular event rate was 153.1/1000 patient-years, and one-year hospitalization rate 612.2/1000 patient-years. Conclusions Good nutritional status, pressure controland higher Hb compliance rate were observed in end-stage renal disease patients with long-term hemodiafiltration, but there was severe hypercalcemia, hyperphosphatemia and hyperparathyroidism in these patients. HDF may be more beneficial for elderly patients and diabetic patients.

       

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