对宫颈癌合并梗阻性肾衰竭患者进行高通量透析与低通量透析的比较分析，结果显示插管后肾功能无显著改善。

A comparative analysis of high-flux and low-flux dialysis in cervical cancer patients with obstructive renal failure showing no significantly improved renal function after catheterisation.

作者信息

Zhang Chen-Li, Xie De-Qiong, Ao Li-Na, Zhu Lei

机构信息

Chen-li Zhang, Department of Nephrology, The Second People's Hospital of Yibin City, Yibin, Sichuan, 644000, P.R. China.

De-qiong Xie, Department of Nephrology, The Second People's Hospital of Yibin City, Yibin, Sichuan, 644000, P.R. China.

出版信息

Pak J Med Sci. 2021 Jul-Aug;37(4):1014-1019. doi: 10.12669/pjms.37.4.3515.

DOI:10.12669/pjms.37.4.3515

PMID:34290775

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8281144/

Abstract

OBJECTIVE

This study aims to compare the clinical application value of high-flux dialysis with low-flux dialysis in patients without significantly improved renal function after cervical cancer and obstructive renal failure catheterisation.

METHODS

This prospective randomised study was conducted from January 2018 to December 2019. Eighty cervical cancer patients with obstructive renal failure who showed no significant renal function improvement after catheterisation were randomised into two groups (n = 40 in each group) in the Second People's Hospital of Yibin City. High-flux and low-flux dialysis were employed in the experimental group and the control group, respectively. Treatments in both groups were provided every other day, with the whole course lasting one week. Data were recorded before and after dialysis included inflammatory factors such as IL-6, CRP and TNF-a, large and moderate molecular toxins (e.g., β2 micro-globulin, parathyrin (PTH) and cysteine protease inhibitor). Renal function changes during the dialysis were also recorded. Afterwards, the two groups were compared regarding the overall efficacy.

RESULTS

Both the experimental group and the control group experienced a significant decrease in IL-6, CRP, TNF-a, β2 micro-globulin, PTH and cysteine protease inhibitor, with the decrease in the experimental group being more evident (p < 0.05). After dialysis was completed, the experimental group restored renal function indicators such as Cre, CysC and serum K+ levels more quickly than the control group (p < 0.05). The effective rate was 100% for the experimental group and 87.5% for the control group. The intragroup difference in the efficacy.was significant.

CONCLUSIONS

High-flux dialysis appears to be more beneficial for cervical cancer patients with obstructive renal failure, showing no significant improvement in renal function after catheterisation. It restored renal function more quickly, had more radical draining of inflammatory factors and large and moderate molecular toxins, and had a higher overall effective rate.

摘要

目的

本研究旨在比较高通量透析与低通量透析在宫颈癌合并梗阻性肾衰竭导管置入术后肾功能未显著改善患者中的临床应用价值。

方法

本前瞻性随机研究于2018年1月至2019年12月进行。宜宾市第二人民医院将80例宫颈癌合并梗阻性肾衰竭且导管置入术后肾功能无显著改善的患者随机分为两组（每组n = 40）。实验组和对照组分别采用高通量透析和低通量透析。两组均隔天进行治疗，整个疗程持续一周。记录透析前后的数据，包括白细胞介素-6（IL-6）、C反应蛋白（CRP）和肿瘤坏死因子-α（TNF-α）等炎症因子，以及大分子和中分子毒素（如β2微球蛋白、甲状旁腺素（PTH）和半胱氨酸蛋白酶抑制剂）。还记录透析过程中的肾功能变化。之后，比较两组的总体疗效。

结果

实验组和对照组的IL-6、CRP、TNF-α、β2微球蛋白、PTH和半胱氨酸蛋白酶抑制剂均显著降低，实验组的降低更为明显（p < 0.05）。透析完成后，实验组的肌酐（Cre）、胱抑素C（CysC）和血清钾离子（K+）水平等肾功能指标恢复速度比对照组更快（p < 0.05）。实验组的有效率为100%，对照组为87.5%。组内疗效差异显著。