Department of Nephrology, Langfang Anci District Hospital, Langfang, China.
Department of Nephrology and Endocrinology, Langfang Traditional Chinese Medicine Hospital, Langfang, China.
Blood Purif. 2022;51(9):739-746. doi: 10.1159/000518857. Epub 2022 Jan 14.
Patients with maintenance hemodialysis (MHD) generally have a microinflammatory state. The aim of this study was to investigate the effects of hemodialysis (HD) combined with hemoperfusion (HP) on microinflammatory state in elderly patients with MHD.
One hundred and fifty elderly patients with MHD were randomly divided into the control group and the observation group. The control group received simple HD treatment, and the observation group received combined HD + HP treatment on the basis of the control group. After 6 months of continuous treatment, the patients were evaluated to compare the quality of life, inflammation, adverse reactions, and nutritional indicators in the 2 groups before and after treatment.
There was no significant difference in the quality of life between the 2 groups before treatment. After treatment, the scores of psychological aspects, physiological aspects, social aspects, environmental aspects, and independent ability in the observation group were higher than those in the control group, with statistical significance (p < 0.05). There was no statistical significance in the level of inflammation between 2 groups before treatment. After treatment, the levels of hs-CRP, Hcy, IL-6, and TNF-α in the observation group were significantly lower than those in the control group, with statistical significance (p < 0.05). The incidence of dry mouth, skin reaction, neuritis, and subcutaneous tissue fibrosis in the observation group was lower than that in the control group, with statistical significance (p < 0.05). There was no statistical significance in nutritional level indexes between 2 groups before treatment (p1 > 0.05). After treatment, the levels of hemoglobin, total protein, albumin, and transferrin in the observation group were significantly higher than those in the control group, with statistical significance (p < 0.05).
The clinical effect of HD combined with HP in elderly MHD patients is significant, which can effectively reduce the incidence of adverse reactions and inflammation in the patients and improve the quality of life and nutritional indicators of the patients.
维持性血液透析(MHD)患者通常存在微炎症状态。本研究旨在探讨血液透析(HD)联合血液灌流(HP)对老年 MHD 患者微炎症状态的影响。
将 150 例老年 MHD 患者随机分为对照组和观察组。对照组给予单纯 HD 治疗,观察组在对照组基础上给予 HD+HP 联合治疗。连续治疗 6 个月后,比较两组患者治疗前后的生活质量、炎症、不良反应及营养指标。
两组患者治疗前的生活质量比较,差异无统计学意义。治疗后,观察组心理方面、生理方面、社会方面、环境方面及独立能力评分均高于对照组,差异有统计学意义(p<0.05)。两组患者治疗前的炎症水平比较,差异无统计学意义。治疗后,观察组 hs-CRP、Hcy、IL-6、TNF-α 水平均低于对照组,差异有统计学意义(p<0.05)。观察组口干、皮肤反应、神经炎、皮下组织纤维化的发生率低于对照组,差异有统计学意义(p<0.05)。两组患者治疗前的营养水平指标比较,差异无统计学意义(p1>0.05)。治疗后,观察组血红蛋白、总蛋白、白蛋白、转铁蛋白水平均高于对照组,差异有统计学意义(p<0.05)。
HD 联合 HP 治疗老年 MHD 患者的临床效果显著,能有效降低患者不良反应及炎症的发生率,提高患者的生活质量和营养指标。