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高通量透析改善尿毒症患者的肺通气功能。

High-flux dialysis improves pulmonary ventilation function in uremic patients.

机构信息

Division of Nephrology, Department of Internal Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230001, P.R. China.

出版信息

Mol Med Rep. 2013 May;7(5):1603-6. doi: 10.3892/mmr.2013.1373. Epub 2013 Mar 14.

Abstract

Lung injury commonly accompanies uremia caused by renal failure. Uremia is typically treated using hemodialysis (dialysis) to restore electrolyte and fluid balance. A more recent, less commonly used method, high-flux dialysis, has not yet been investigated for its potential benefit to lung function. The aim of the present study was to determine whether high‑flux dialysis affects pulmonary function. We assessed various pulmonary function parameters in patients with uremia before and after routine or high‑flux dialysis. Pulmonary function was assessed via determination of the forced vital capacity (FVC), maximum breathing capacity (MBC), forced expiratory volume in 1 sec (FEV1), peak expiratory flow (PEF), maximal midexpiratory flow (MMEF) curve, maximal expiratory flow in 25% vital capacity (V25) and diffusion capacity of the lungs for carbon monoxide (DLco) in 42 patients with uremia and 24 healthy individuals. Patients with uremia were divided into two groups; the high‑flux group (treated with high-flux dialysis; n=21) and the routine group (treated with conventional dialysis; n=21). Lung function was reassessed in the two groups after 3 months of dialysis. The two groups of patients with uremia exhibited reduced lung function parameters compared with healthy individuals (all P<0.05), indicating the presence of impaired lung function secondary to uremia. Following dialysis, the FEV1, PEF, MMEF and V25 values increased significantly compared with their respective baseline values prior to treatment for each group (ANOVA, P<0.05). Furthermore, increases were more marked in patients treated with high-flux dialysis compared with those treated using routine dialysis (P<0.05). Thus, lung injury caused by uremia was shown to be improved following dialysis, with high-flux dialysis offering a greater benefit than routine dialysis.

摘要

肺损伤通常伴随着肾衰竭引起的尿毒症。尿毒症通常采用血液透析(透析)来恢复电解质和液体平衡来治疗。一种较新的、不太常用的方法,高通量透析,尚未研究其对肺功能的潜在益处。本研究旨在确定高通量透析是否会影响肺功能。我们评估了常规或高通量透析前后尿毒症患者的各种肺功能参数。通过测定用力肺活量(FVC)、最大呼吸量(MBC)、1 秒用力呼气量(FEV1)、呼气峰流速(PEF)、最大中期呼气流速(MMEF)曲线、最大呼气量在 25%肺活量(V25)和肺一氧化碳弥散量(DLco)来评估肺功能在 42 例尿毒症患者和 24 例健康个体中。尿毒症患者分为两组;高通量组(接受高通量透析治疗;n=21)和常规组(接受常规透析治疗;n=21)。透析 3 个月后,重新评估两组患者的肺功能。两组尿毒症患者的肺功能参数均低于健康个体(均 P<0.05),表明存在尿毒症引起的肺功能受损。与治疗前相比,透析后 FEV1、PEF、MMEF 和 V25 值均显著升高,两组均有统计学差异(ANOVA,P<0.05)。此外,高通量透析组的增加幅度明显大于常规透析组(P<0.05)。因此,透析后尿毒症引起的肺损伤得到改善,高通量透析比常规透析更有优势。

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