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目的探讨三种不同血液净化方法在尿毒症患者毒素清除中的应用效果。方法本院2013年1~12月接诊的尿毒症患者中选取57例,随机分为血液透析组(HD组)、血液透析滤过组(HDF组)、血液透析联合血液灌流组(HD+HP组),比较3组治疗前后血清磷、β2微球蛋白(β2-MG)、尿素氮(BUN)、全段甲状旁腺激素(iPTH)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、血清脂蛋白(a)[LP(a)]、C反应蛋白(CRP)、载脂蛋白A1(ApoA1)、载脂蛋白B100(ApoB100)、脂蛋白酯酶(LPL)、肿瘤坏死因子-α(TNF-α)指标的变化。结果治疗前各项指标差异无统计学意义(P>0.05);治疗后,3组患者各项指标均有改善(P<0.05),且HD+HP组的改善效果优于其他两组(P<0.05)。结论血液透析联合血液灌流治疗尿毒症,能够取得理想的治疗效果,可快速排除患者体内的毒素,对改善循环有积极作用。
Objective To explore the effect of three different methods of blood purification on toxin removal in uremic patients. Methods 57 cases of uremic patients admitted from January to December 2013 in our hospital were randomly divided into three groups: HD group, HDF group, HD combined with hemodilution group, HP group). The changes of serum phosphorus, β2-MG, BUN, iPTH, LDL, HDL-C, (HDL), serum lipoprotein (a) [LP (a)], C-reactive protein (CRP), apolipoprotein A1 (ApoAl), apolipoprotein B100 (ApoB100), lipoprotein lipase (LPL) Factor-α (TNF-α) changes in indicators. Results There was no significant difference in each index before treatment (P> 0.05). After treatment, the indexes in all three groups improved (P <0.05), and the improvement in HD + HP group was better than the other two groups <0.05). Conclusion Hemodialysis combined with hemoperfusion treatment of uremia, can achieve the desired effect of treatment, can quickly rule out toxins in patients with a positive effect on the improvement of circulation.