血液透析联合血液灌流在糖尿病肾病患者中的应用效果

郑长新 徐文珠 连景铃

[摘要] 目的 分析血液透析联合血液灌流治疗糖尿病肾病的成效。方法 挑选2018年5月—2019年5月在该院治疗的60例糖尿病肾病患者，选择数字表法将患者分成观察组与对照组，每组30例。对照组患者采用血液透析疗法，观察组患者采用血液透析联合血液灌流疗法，观察并对比两组的炎症因子、营养状况、肾脏生化指标和血糖相关指标。结果 两组患者治疗前的CRP、IL-6、PTH、BUN、Hb、FINS和HOMA-IR水平对比，差异无统计学意义（P>0.05）。治疗后，观察组的CRP、IL-6、PTH、BUN、Hb、FINS和HOMA-IR水平明显优于对照组，差异有统计学意义（P<0.05）。结论 血液透析联合血液灌流治疗糖尿病肾病，利于改善患者微炎癥状况和营养状况，降低胰岛素抵抗，抑制病情进展。

[关键词] 血液透析;血液灌流;糖尿病肾病;炎症;营养状况

[中图分类号] R692          [文献标识码] A          [文章编号] 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）属于能量代谢异常综合征，有较高的致残率、致死率，会诱发慢性肾功能衰竭、终末期糖尿病肾病，成为当前难治疾病中的一种。据相关调查统计，在Ⅰ型糖尿病患者当中，有接近40%的患者在患病多年后，病情演变成糖尿病性肾病（DN）终末期肾功能衰竭，主要表征是轻微炎症状态，机体出现营养不良，生活品质大大下降，生存几率也显著下降[1]。目前临床治疗糖尿病肾病较为安全且有效的治疗手段之一就是血液透析（HD），而血液灌流（HP）则有利于对肾功能损失实现代偿，两种治疗手段并用被普遍应用于临床。该文分析血液透析联合血液灌流治疗糖尿病肾病的成效，挑选2018年5月—2019年5月在该院治疗的60例糖尿病肾病患者作为研究对象，现报道如下。