摘要
探讨腹膜透析(PD)用于老年终末期肾病(ESRD)患者对微炎症状态、血清胎球蛋白A、脂联素水平及生存率的影响,回顾性选取2021年6月至2023年6月本院收治的136例老年ESRD患者的临床资料,据透析治疗方法分为高通量血液透析(HFHD)组(n=78)与PD组(n=58),两组均治疗3个月。评价两组治疗的疗效及安全性,比较两组治疗前后肾功能(肾小球滤过率、尿素氮、血肌酐)、炎症因子[白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)及肿瘤坏死因子-α(TNF-α)]、胎球蛋白A、脂联素水平的差异。对患者随访1年,绘制Kaplan-Meier曲线比较两组的生存率。PD组总有效率高于HFHD组(94.83%vs 82.05%,P<0.05);治疗后,两组肾小球滤过率、尿素氮、血肌酐、IL-6、hs-CRP、TNF-α、胎球蛋白A、脂联素均下降,且PD组低于HFHD组(P<0.05);两组并发症发生率比较无显著差异(P>0.05)。随访1年,PD组、HFHD组生存率分别为91.38%(53/58)、88.46%(69/78),两组比较无显著差异(P>0.05)。PD治疗老年ESRD患者的效果显著,能有效改善肾功能和微炎症状态,降低胎球蛋白A和脂联素水平,且安全性好,对生存率无明显影响。
The aim of this study was to explore the effects of peritoneal dialysis(PD)on microinflammatory state,serum fetuin A,adiponectin and survival rate in elderly patients with end-stage renal disease(ESRD).In this study,a retrospective collection was performed on the clinical data of 136 elderly patients with ESRD in the hospital between June 2021 and June 2023.According to different dialysis methods,patients were divided into high flux hemodialysis(HFHD)group(n=78)and PD group(n=58).All patients were treated for 3 months.The curative effect and safety in the two groups were evaluated.The differences in renal function(glomerular filtration rate,blood urea nitrogen,serum creatinine),inflammatory factors[interleukin-6(IL-6),hypersensitive Creactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)],fetuin A and adiponectin before and after treatment were compared between the two groups.All patients were followed up for 1 year,and survival rates in the two groups were compared by Kaplan-Meier curves.The total response rate of PD group was higher than that of HFHD group(94.83%vs 82.05%,P<0.05).After treatment,glomerular filtration rate,blood urea nitrogen,serum creatinine,IL-6,hs-CRP,TNF-α,fetuin A and adiponectin were decreased in both groups,which were lower in PD group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).After 1 year of follow-up,there was no significant difference in survival rate between PD group and HFHD group[91.38%(53/58)vs 88.46%(69/78),P>0.05].The curative effect of PD is significant in elderly patients with ESRD which effectively improved renal function and microinflammatory state,reduced levels of fetuin-A and adiponectin,and has good safety and no significant effects on survival rate.
作者
许超群
赵翠
陈娜
崔雪
王娜
贾利敏
黄雪丽
XU Chaoqun;ZHAO Cui;CHEN Na;CUI Xue;WANG Na;JIA Limin;HUANG Xueli(Department of Nephrology,Oncology Branch of Cangzhou People's Hospital,Cangzhou 061000,China)
出处
《药物生物技术》
2025年第5期681-685,共5页
Pharmaceutical Biotechnology
关键词
老年
终末期肾病
腹膜透析
高通量血液透析
疗效
胎球蛋白A
脂联素
生存率
Elderly
End-stage renal disease
Peritoneal dialysis
High flux hemodialysis
Curative effect
Fetuin A
Adiponectin
Survival rate
