摘要
目的 分析血液灌流联合血液透析对尿毒症皮肤瘙痒临床疗效、β2-微球蛋白(β2-MG)及甲状旁腺激素(PTH)的影响.方法 选取2021 年12 月—2022 年10 月收治的尿毒症皮肤瘙痒201 例,根据治疗方案不同分为对照组98 例和研究组103 例.对照组采用血液透析治疗,研究组采用血液灌流联合血液透析治疗.比较 2 组临床疗效、炎性因子[白细胞介素-1(IL-1)、IL-6、降钙素原(PCT)]、肾功能指标[血尿素(BUN)、血清肌酐(Scr)、β2-MG]、钙磷代谢指标[血清磷、钙、PTH]及复发率.结果 研究组总有效率为91.26%(94/103)高于对照组的79.59%(78/98)(P＜0.05).治疗后,2 组IL-1、IL-6、PCT、BUN、Scr、β2-MG、PTH及血清磷水平均较治疗前下降,且研究组低于对照组(P＜0.05).治疗后,2 组血清钙水平较治疗前上升,且研究组高于对照组(P＜0.05).研究组复发率为 5.83%(6/103)低于对照组的43.88%(43/98)(P＜0.05).结论 血液灌流联合血液透析治疗尿毒症皮肤瘙痒的效果显著,可改善炎症状态,降低PTH、β2-MG水平,有效清除患者体内大中分子代谢物质.
Abstract
Objective To analyze the effects of hemoperfusion combined with hemodialysis on the clinical efficacy,β2-microglobulin(β2-MG)and parathyroid hormone(PTH)of uremic pruritus(UP).Methods In total,201 patients with UP treated in our hospital from December 2021 to October 2022 were selected,and according to different treatment plans,they were divide into control group(n =98)and research group(n =103).The control group was treated with hemodialysis,and the research group was treated with hemoperfusion combined with hemodialysis.The clinical efficacy,inflammatory factors[interleukin-1(IL-1),interleukin-6(IL-6),procalcitonin(PCT)],renal function indexes[serum urea nitrogen(BUN),creatinine(Scr),β2-MG],calcium and phosphorus metabolism indexes(serum phosphorus,calcium,PTH)and recurrence rate of the two groups were compared.Results The total effective rate was 91.26%(94/103)in the research group and 79.59%(78/98)in the control group(P＜0.05).After treatment,the levels of IL-1,IL-6,PCT,BUN,Scr,β2-MG,PTH and serum phosphorus in the two groups were lower than those before treatment,and lower in the research group than in the control group(P＜0.05).After treatment,serum calcium in the two groups was higher than that before treatment,and higher in the research group than in the control group(P＜0.05).The recurrence rate of the research group was lower than that of the control group[5.83%(6/103)vs.43.88%(43/98)](P＜0.05).Conclusion Hemoperfusion combined with hemodialysis is effective in the treatment of UP,which can improve the inflammatory state,reduce the levels of PTH and β2-MG,and effectively remove large and medium-sized metabolites in the body of patients.
基金项目
秦皇岛市科学技术研究与发展计划项目(202004A069)
国家科技期刊平台
NSTL
万方数据