血液透析聯合血液灌流在糖尿病腎病患者中的應用效果

鄭長新 徐文珠 連景鈴

[摘要] 目的 分析血液透析聯合血液灌流治療糖尿病腎病的成效。方法 挑選2018年5月—2019年5月在該院治療的60例糖尿病腎病患者，選擇數字表法將患者分成觀察組與對照組，每組30例。對照組患者采用血液透析療法，觀察組患者采用血液透析聯合血液灌流療法，觀察并對比兩組的炎癥因子、營養狀況、腎臟生化指標和血糖相關指標。結果 兩組患者治療前的CRP、IL-6、PTH、BUN、Hb、FINS和HOMA-IR水平對比，差異無統計學意義（P>0.05）。治療后，觀察組的CRP、IL-6、PTH、BUN、Hb、FINS和HOMA-IR水平明顯優于對照組，差異有統計學意義（P<0.05）。結論 血液透析聯合血液灌流治療糖尿病腎病，利于改善患者微炎癥狀況和營養狀況，降低胰島素抵抗，抑制病情進展。

[關鍵詞] 血液透析;血液灌流;糖尿病腎病;炎癥;營養狀況

[中圖分類號] R692? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1672-4062（2020）09（b）-0169-03

Application Effect of Hemodialysis Combined with Hemoperfusion in Patients with Diabetic Nephropathy

ZHENG Chang-xin， XU Wen-zhu， LIAN Jing-ling

Department of Nephrology， Mindong Hospital of Ningde City， Ningde， Fujian Province， 355000 China

[Abstract] Objective To analyze the effectiveness of hemodialysis combined with hemoperfusion in the treatment of diabetic nephropathy. Methods Select 60 patients with diabetic nephropathy who were treated in the hospital from May 2018 to May 2019， and choose the digital table method to divide the patients into observation group and control group， with 30 cases in each group. Patients in the control group were treated with hemodialysis， and patients in the observation group were treated with hemodialysis combined with hemoperfusion to observe and compare the inflammatory factors， nutritional status， renal biochemical indexes and insulin-related indexes of the two groups. Results The comparison of the levels of CRP， IL-6， PTH， BUN， Hb， FINS and HOMA-IR before treatment between the two groups of patients，the difference was not statistically significant（P>0.05）. After treatment， the levels of CRP， IL-6， PTH， BUN， Hb， FINS and HOMA-IR in the observation group were significantly better than those in the control group，the difference was statistically significant（P<0.05）. Conclusion Hemodialysis combined with hemoperfusion in the treatment of diabetic nephropathy is beneficial to improve the patient's micro-inflammatory and nutritional status， reduce insulin resistance， and inhibit disease progression.

[Key words] Hemodialysis; Hemoperfusion; Diabetic nephropathy; Inflammation; Nutritional status

糖尿病（DM）屬于能量代謝異常綜合征，有較高的致殘率、致死率，會誘發慢性腎功能衰竭、終末期糖尿病腎病，成為當前難治疾病中的一種。據相關調查統計，在Ⅰ型糖尿病患者當中，有接近40%的患者在患病多年后，病情演變成糖尿病性腎病（DN）終末期腎功能衰竭，主要表征是輕微炎癥狀態，機體出現營養不良，生活品質大大下降，生存幾率也顯著下降[1]。目前臨床治療糖尿病腎病較為安全且有效的治療手段之一就是血液透析（HD），而血液灌流（HP）則有利于對腎功能損失實現代償，兩種治療手段并用被普遍應用于臨床。該文分析血液透析聯合血液灌流治療糖尿病腎病的成效，挑選2018年5月—2019年5月在該院治療的60例糖尿病腎病患者作為研究對象，現報道如下。