摘要
目的探讨改良配对血浆滤过吸附技术在维持性血液透析患者中的临床应用效果,为优化该类患者的血液净化治疗方案提供依据。方法本研究纳入40例接受维持性血液透析的患者作为观察对象,采用随机数字表法将其均分为观察组与对照组,每组各20例。两组患者均接受常规血液透析治疗作为基础治疗,观察组在基础治疗上每月加用1次改良配对血浆滤过吸附治疗,对照组在基础治疗上每月加用1次血液滤过治疗。比较两组患者常规生化指标(β_(2)微球蛋白、甲状旁腺激素、胱抑素C、同型半胱氨酸)、炎症指标[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)]、凝血指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)]、不良事件发生情况。结果治疗后,两组患者β_(2)微球蛋白、甲状旁腺激素、胱抑素C、同型半胱氨酸水平均较本组治疗前有所下降,且观察组下降幅度显著大于对照组(P<0.05)。治疗后,两组患者hs-CRP、IL-6水平均较本组治疗前有所下降,且观察组hs-CRP(4.25±1.56)mg/L、IL-6(7.85±2.12)pg/ml显著低于对照组的(8.62±2.13)mg/L、(13.42±3.05)pg/ml(P<0.05)。治疗前后,两组患者PT、APTT、FIB水平比较,差异均无统计学意义(P>0.05)。治疗过程中,观察组出现低血压1例,不良事件发生率为5.0%;对照组出现低血压2例、出血1例,不良事件发生率为15.0%。观察组不良事件发生率低于对照组,但差异无统计学意义(χ^(2)=1.111,P=0.292>0.05)。结论改良配对血浆滤过吸附技术能高效去除维持性血液透析患者体内的蛋白结合类毒素与炎症因子,改善患者微炎症状态,且对凝血功能无明显影响,安全性良好,值得临床推广应用。
Objective To explore the clinical efficacy of modified coupled plasma filtration adsorption in maintenance hemodialysis patients,and provide evidence for optimizing the blood purification treatment regimen for such patients.Methods A total of 40 patients on maintenance hemodialysis were selected as study subjects and divided into an observation group and a control group according to the random numerical table,with 20 cases in each group.Both groups received routine hemodialysis treatment.On this basis,the observation group was given modified coupled plasma filtration adsorption once a month,while the control group was given hemofiltration once a month.Patients in both groups were compared for routine biochemical indicators(β_(2)-microglobulin,parathyroid hormone,cystatin C,homocysteine),inflammatory indicators[high sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)],coagulation indicators[prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB)],and the occurrence of adverse events.Results Following treatment,levels ofβ_(2)-microglobulin,parathyroid hormone,cystatin C,and homocysteine decreased in both patient groups compared to baseline in their respective group.Moreover,the reduction in the observation group was significantly greater than the control group(P<0.05).Following treatment,both groups exhibited reduced levels of hs-CRP and IL-6 compared to baseline in their respective group.Moreover,the observation group demonstrated significantly lower levels of hs-CRP(4.25±1.56)mg/L and IL-6(7.85±2.12)pg/ml than the control group[(8.62±2.13)mg/L and(13.42±3.05)pg/ml](P<0.05).Comparisons of PT,APTT,and FIB levels between the two groups before and after treatment showed no statistically significant differences(P>0.05).During treatment,1 case of hypotension occurred in the observation group,yielding an adverse reaction rate of 5.0%;the control group reported 2 cases of hypotension and 1 case of bleeding,resulting in an adverse reaction rate of 15.0%.The incidence of adverse events in the observation group was lower than that in the control group,but the difference was not statistically significant(χ^(2)=1.111,P=0.292>0.05).Conclusion Modified coupled plasma filtration adsorption can effectively remove protein-bound toxins and inflammatory factors in MHD patients,improve their microinflammatory state.It demonstrates no significant impact on coagulation function and exhibits favorable safety profiles,making it worthy of clinical promotion.
作者
谢琬娜
张雷
周海燕
李柳莹
米兰岚
XIE Wan-na;ZHANG Lei;ZHOU Hai-yan(Department of Nephrology,Wuzhou Workers'Hospital,Wuzhou 543000,China)
出处
《中国现代药物应用》
2026年第8期22-26,共5页
Chinese Journal of Modern Drug Application
基金
梧州市科技计划项目(项目编号:202202122)。
关键词
改良配对血浆滤过吸附
维持性血液透析
蛋白结合类毒素
微炎症状态
凝血功能
Modified coupled plasma filtration adsorption
Maintenance hemodialysis
Protein-bound toxins
Microinflammatory state
Coagulation function
