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目的探讨不同血液净化方式对尿毒症患者疗效及预后影响。方法将收治透析1～4年的96例尿毒症患者分别予以HD、HF以及HFHD进行治疗,透析前和治疗6个月后分别常规检测Cr、P,放射免疫法测定β2-MG、血总胆固醇、甘油三酯和低密度脂蛋白,采用QOL-C30进行健康状况调查1次。结果三组患者在透析前,血液各项指标均无统计学差异(P>0.05),具有可比性;透析6个月后,三组患者的Cr、P变化不明显,无统计学差异(P>0.05),HFHD组的β2-MG、血总胆固醇、甘油三酯和低密度脂蛋白下降较HD组显著(P<0.05,P<0.01),HF组的甘油三酯和低密度脂蛋白下降较HD组均有统计学差异(P<0.01)。与透析前比较,透析治疗后患者在躯体功能、认知功能上改善显著(P<0.01),在社会功能、整体健康状况上改善明显(P<0.05);透析6个月后组间比较,HFHD组的各项健康因子较HD组有统计学差异(P<0.05),HF组与HD组未见明显差异(P>0.05)。结论三种血液透析方法均能改善酸碱平衡及电解质紊乱,但高通量血液透析组在提高治疗效果和改善患者生存质量方面的作用优于血液透析滤过组和血液透析组。
Objective To investigate the effects of different blood purification methods on the efficacy and prognosis of patients with uremia. Methods Ninety-six patients with uremia who received dialysis for 1 to 4 years were treated with HD, HF and HFHD respectively. Cr and P were measured routinely before dialysis and 6 months after treatment. Β2-MG and total cholesterol , Triglycerides and low density lipoprotein, using QOL-C30 health survey 1. Results Before dialysis, there were no significant differences among the three groups (P> 0.05). After 6 months of dialysis, there was no significant difference between the three groups (P > 0.05). The levels of β2-MG, total cholesterol, triglyceride and low density lipoprotein in HFHD group were significantly lower than those in HD group (P <0.05, P <0.01), while triglyceride and low density lipoprotein Compared with HD group, there was a significant difference (P <0.01). Compared with those before dialysis, the patients had significant improvement in somatic function and cognitive function after dialysis (P <0.01), and improved significantly in social function and general health (P <0.05). After 6 months of dialysis, There was a significant difference in all health factors between HF group and HD group (P <0.05), but there was no significant difference between HF group and HD group (P> 0.05). Conclusion All three hemodialysis methods can improve acid-base balance and electrolyte imbalance, but the effect of high-flux hemodialysis group is better than that of hemodiafiltration group and hemodialysis group in improving therapeutic effect and improving quality of life of patients.