目的 比较终末期肾病(ESRD)通过高通量血液透析(HFHD)与血液透析滤过(HDF)治疗的效果和远期生存率差异.方法 选取于郑州七院接受治疗的ESRD患者68例,根据入院时间随机分为通量组和对照组,各34例.通量组予以HFHD疗法,对照组则以HDF进行治疗,两组患者均随访6年;比较治疗前与治疗后1年、3年、6年时两组患者血液小分子毒素[血清肌酐(SCr)、血清尿素氮(BUN)]和中、大分子毒素[β2-微球蛋白(β2-MG)、血清全段甲状旁腺激素(iPTH)]水平,比较治疗后不同阶段患者生存率差异.结果 治疗1年、3年后,两组患者生存率比较无统计学意义(P＞0.05);治疗6年后,通量组患者生存率明显高于对照组(P＜0.05).治疗1年、3年、6年后,两组患者血液小分子毒素水平较治疗前均明显降低(均P＜ 0.05),且同一时期组间比较差异无统计学意义(P＞0.05);通量组患者血液的中、大分子毒素水平较治疗前有明显降低,且明显低于同期对照组(均P＜ 0.05).结论 HFDF在治疗ESRD时能取得比HDF更好的疗效及远期生存率.%Objective To explore the curative effects and long-term survival rates of high flux hemodialysis (HFHD) versus hemodiafiltration (HDF) for patients with end stage renal disease (ESRD).Methods 68 patients with ESRD treated at our hospital were randomly divided into a flux group (34 cases) and a control group (34 cases) according to their admission times.The flux group were treated with HFHD and the control group HDF.Both groups were followed up for 6 years.The levels of blood micromolecule toxins [serum creatinine (SCr)and blood urea nitrogen (BUN)],medium and large molecular toxins [β2-microglobulin (β-MG),serum intact parathyroid hormone (iPTH)] before and 1,3,and 6 years after the treatment,and the differences of survival rates at different stages after the treatment in the two groups were compared.Results 1 and 3 years after the treatment,there were no statistical differences in survival rates between the two groups (P ＞ 0.05);6 years after the treatment,the survival rate in the flux group was significantly higher than that in the control group (P ＜ 0.05).1,3,and 6 years after the treatment,the levels of blood micromolecule toxins in the two groups significantly decreased (all P＜ 0.05),but with no statistical differences between these two groups during the same period (P ＞ 0.05).1,3,and 6 years after the treatment,the levels of medium and large molecular toxins were significantly lower than those before the treatment in the flux group and were in the flux group than in the control group (all P＜ 0.05).Conclusion HFDF can achieve better curative effect and long-term survival rate than HDF in the treatment of ESRD.
展开▼
