摘要
目的探讨血液透析联合血液灌流对尿毒症患者铁代谢及内环境代谢的影响。方法回顾性分析2019年5月至2021年1月于惠州市中心人民医院血液净化中心进行透析的尿毒症患者共100例,随机分为两组,每组50例,其中联合组采用血液透析联合血液灌流,对照组采用常规血液透析。对比两组患者干预前和干预后6个月的血浆白蛋白、前白蛋白及血红蛋白;比较两组的血磷(P)、钙(Ca)、钙磷乘积、血清甲状旁腺素(iPTH);比较两组患者骨代谢及铁代谢指标,包括骨性标记物Ⅰ型前胶原氨基端延长肽(P1NP)、β-胶原降解产物(β-CTX)、骨钙素(BGP),血清铁、铁蛋白(Fer)、转铁蛋白(TRF)、总铁结合力(TIBC)、转铁蛋白饱和度(TSAT)。结果两组患者治疗前的血浆白蛋白、前白蛋白、血红蛋白、转铁蛋白、平均P、Ca、钙磷乘积和iPTH水平对比差异均无统计学意义(P>0.05),联合治疗组的血浆白蛋白、前白蛋白、血红蛋白和Ca水平显著高于对照组,而联合治疗组的P、钙磷乘积和iPTH水平显著低于对照组,差异具有统计学意义(P<0.05);两组治疗前P1NP、β-CTX和BGP水平对比差异无统计学意义,联合治疗组的P1NP、β-CTX和BGP水平均显著低于对照组,差异具有统计学意义(P<0.05)。两组治疗前Fer、TRF、TIBC及TSAT水平对比差异无统计学意义,治疗6个月后两组的血清铁、TIBC及TSAT水平均较治疗前上升,且联合治疗组的血清铁、TIBC及TSAT水平均显著高于对照组(P<0.05)。结论血液透析联合血液灌流能改善尿毒症患者的营养状态,纠正钙磷代谢紊乱,明显改善骨代谢和铁代谢转化。
Objective To investigate the effect of hemodialysis combined with hemoperfusion on iron metabolism and internal environment metabolism in patients with uremia.Methods A total of 100 uremic patients who underwent dialysis in me from May 2019 to January 2021 were selected and randomly divided into two groups with 50 cases in each group.The combined group used hemodialysis combined with hemoperfusion,and the control group used conventional hemodialysis.The changes of plasma albumin,prealbumin,hemoglobin and transferrin were compared between the two groups after intervention.And the blood phosphorus(P),calcium(Ca),calcium phosphorus product,and serum thyroid status of the two groups.Bone metabolism and iron metabolism indexes were compared between the two groups,including bone markers typeⅠprocollagen amino terminal extension peptide(P1NP),β-collagen degradation product(β-CTX),osteocalcin(BGP),serum iron,ferritin(Fer),transferrin(TRF),total iron binding capacity(TIBC),transferrin saturation(TSAT).Results There was no significant difference in the levels of plasma albumin,prealbumin,hemoglobin,transferrin,average P,Ca,calcium-phosphorus product and iPTH before treatment(P>0.05).After 6 months of treatment,the levels of plasma albumin,prealbumin,hemoglobin,transferrin and calcium in the combined group were significantly higher than those in the control group,while the levels of P,calcium and phosphorus products and iPTH in the combined group were significantly lower than those in the control group(P<0.05).Also,there was no statistically significant difference in the levels of P1NP,β-CTX and BGP between the two groups before treatment.The levels of P1NP,β-CTX and BGP in the combination group were significantly lower than those in the control group(P<0.05).Moreover,the levels of serum iron,TIBC and TSAT in the two groups were increased compared with those before treatment,and the levels of serum iron,TIBC and TSAT in the combined group were significantly higher than those in the control group(P<0.05).Conclusions Hemodialysis combined with hemoperfusion can improve the nutritional status of patients with uremia,correct the disorder of calcium and phosphorus metabolism,and significantly improve the transformation of bone metabolism and iron metabolism.
作者
黄朝晖
刘仁华
杨立文
Zhaohui Huang;Renhua Liu;Liwen Yang(Huizhou Municipal Central Hospital,Department ofnephrology,516000 Huizhou,Guangdong,China)
出处
《中华肥胖与代谢病电子杂志》
2022年第3期169-173,共5页
Chinese Journal Of Obesity and Metabolic Diseases：Electronic Edition
关键词
血液透析
血液灌流
尿毒症
内环境
铁代谢
Hemodialysis
Hemoperfusion
Uremia
Nutrition
Calcium and phosphorus metabolism
作者简介
通信作者:黄朝晖,Email:zhaohuiwawa@126.com
