高通量血液透析对终末期肾衰竭患者细胞免疫、钙磷代谢及β<sub>2</sub>-MG的影响

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摘要目的研究高通量血液透析对终末期肾衰竭患者细胞免疫、钙磷代谢以及β₂-微球蛋白(β₂-Microglobulin,β₂-MG)的影响。方法选取2017-04至2019-04于医院肾内科收治的157例终末期肾衰竭患者作为研究对象,根据患者透析方案进行分组,其中采用高通量血液透析的76例患者作为观察组,采用常规血液透析的81例患者作为对照组,比较两组患者治疗前后生化指标、细胞免疫、β₂-MG以及钙磷代谢情况。结果治疗后观察组SCr水平明显低于对照组(P＜0.05),观察组BUN、ALB以及Hb水平明显高于对照组(P＜0.05)。治疗后观察组患者血磷、iPTH水平以及β₂-MG水平明显低于对照组(P＜0.05),观察组患者血钙明显高于对照组(P＜0.05)。治疗后观察组患者CD3⁺、CD4⁺、CD4⁺/CD8⁺明显高于对照组(P＜0.05)。观察组患者治疗后生活质量评分明显高于对照组(P＜0.05)。结论高通量血液透析能够改善终末期肾衰竭患者机体的免疫功能、钙磷代谢以及β₂-MG情况,可作为临床改善终末期肾衰竭患者生活质量以及延长生存期的有效治疗措施。

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	廖雪娇
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关键词 ：高通量血液透析, 终末期肾衰竭, 细胞免疫, 钙磷代谢, β₂-MG

Abstract：ObjectiveTo study the effects of high-flux hemodialysis (HFHD) on cellular immunity, calcium and phosphorus metabolism and β₂-microglobulin (β₂-Microglobulin,β₂-MG) in patients with end-stage renal failure (ESRD).Methods A total of 157 patients with end-stage renal failure admitted to our Department of Nephrology from April 2017 to April 2019 were enrolled, including 76 patients receiving high-flux hemodialysis as the observation group and another 81 patients undergoing conventional hemodialysis as the control group. The biochemical parameters, cellular immunity, β₂-MG and calcium and phosphorus metabolism were compared before and after treatment.Results After treatment, the expression of SCr in the observation group was significantly lower than that in the control group (P<0.05), while the expressions of BUN, ALB and Hb in the observation group were significantly higher (P<0.05).After treatment, the levels of serum phosphorus, iPTH and β₂-MG in the observation group were significantly lower than those in the control group (P<0.05), while the level of serum calcium in the observation group was significantly higher (P<0.05). After treatment, the levels of CD3⁺, CD4⁺, CD4⁺/CD8⁺ in the observation group were significantly higher than those in the control group (P<0.05). The score of postoperative quality of life of the observation group was significantly higher than that of the control group (P<0.05).Conclusions High-flux hemodialysis can improve the immune function, calcium and phosphorus metabolism and β₂-MG in patients with end-stage renal failure, which can be used as an effective treatment for improving patients’ quality of life and prolonging survival.

Key words： high-flux hemodialysis end-stage renal failure cellular immunity calcium and phosphorus metabolism β₂-MG

收稿日期: 2019-11-11

ZTFLH:

R457.2

通讯作者: 冉玉力,E-mail:wjyyran@163.com

作者简介: 廖雪娇,本科学历,主治医师。

引用本文:

廖雪娇, 蒲正川, 刘丹, 冉玉力. 高通量血液透析对终末期肾衰竭患者细胞免疫、钙磷代谢及β₂-MG的影响[J]. 武警医学, 2020, 31(3): 215-218. LIAO Xuejiao, PU Zhengchuan, LIU Dan, RAN Yuli. Effect of high-flux hemodialysis on cellular immunity, calcium and phosphorus metabolism and β2-MG in patients with end-stage renal failure. Med. J. Chin. Peop. Armed Poli. Forc., 2020, 31(3): 215-218.

链接本文:

http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2020/V31/I3/215

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