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中华肥胖与代谢病电子杂志 ›› 2021, Vol. 07 ›› Issue (01) : 36 -40. doi: 10.3877/cma.j.issn.2095-9605.2021.01.007

所属专题: 文献

论著

不同通量血液透析联合血液透析滤过对胰岛素抵抗尿毒症患者的疗效比较
黄炎驱1,(), 林延明1, 余丹红1   
  1. 1. 529000 江门,江门市人民医院肾内科
  • 收稿日期:2020-10-26 出版日期:2021-02-28
  • 通信作者: 黄炎驱
  • 基金资助:
    江门市医疗卫生领域科技计划项目(2019020100110001026)

Comparison of the curative effect of different flux hemodialysis combined with hemodiafiltration on patients with insulin resistance uremia

Yanqi Huang1,(), Yanming Lin1, Danhong Yu1   

  1. 1. Department of Nephrology, Jiangmen People's Hospital, Jiangmen 529000, China
  • Received:2020-10-26 Published:2021-02-28
  • Corresponding author: Yanqi Huang
引用本文:

黄炎驱, 林延明, 余丹红. 不同通量血液透析联合血液透析滤过对胰岛素抵抗尿毒症患者的疗效比较[J/OL]. 中华肥胖与代谢病电子杂志, 2021, 07(01): 36-40.

Yanqi Huang, Yanming Lin, Danhong Yu. Comparison of the curative effect of different flux hemodialysis combined with hemodiafiltration on patients with insulin resistance uremia[J/OL]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2021, 07(01): 36-40.

目的

对比不同通量血液透析联合血液透析滤过对胰岛素抵抗尿毒症患者的疗效。

方法

选取江门市人民医院2019年5月至2020年8月60例胰岛素抵抗尿毒症患者作为研究对象,随机分为两组,每组30例,分别采用低通量血液透析联合血液透析滤过(LFHD+HDF)和高通量血液透析联合血液透析滤过(HFHD+HDF)干预,对比两组患者治疗前和治疗3个月、6个月的空腹血糖(FPG)、空腹血浆胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR),以及其胆固醇(TC)、三酰甘油(TG)、血清白蛋白(ALB)、血尿素氮(BUN)、肌酐(SCr)、β2-微球蛋白(β2-MG)、甲状旁腺素(PTH)、超敏C反应蛋白(Hs-CRP)等相关指标。

结果

HFHD+HDF组治疗3个月和6个月后的FINS和HOMA-IR水平均低于LFHD+HDF组(P<0.05),且HFHD+HDF组在治疗3个月、6个月后的TC、TG、PTH和Hs-CRP水平显著低于LFHD+HDF组,差异具有统计学意义(P<0.05);HFHD+HDF组在治疗3个月、6个月后的TC、TG、PTH和Hs-CRP水平显著低于LFHD+HDF组(P<0.05),治疗6个月LFHD+HDF组的Kt/V水平显著低于治疗前,而HFHD+HDF组的Kt/V水平显著高于治疗前,且显著高于LFHD+HDF组,差异具有统计学意义(P<0.05)。

结论

高通量血液透析联合血液透析滤过(HFHD+HDF)对比低通量血液透析联合血液透析滤过(LFHD+HDF)能改善胰岛素抵抗尿毒症患者的胰岛素抵抗、机体脂代谢水平,并改善患者的肾功能。

Objective

To compare the effects of different fluxes of hemodialysis combined with hemodiafiltration on insulin-resistant uremia patients.

Methods

A total of 60 insulin-resistant uremia patients from Jiangmen People's Hospital from May 2019 to August 2020 were selected as the research subjects. They were randomly divided into two groups, 30 cases in each group, and they were treated with low-flux hemodialysis combined with hemodiafiltration. (LFHD+HDF) and high flux hemodialysis combined with hemodiafiltration (HFHD+HDF) intervention. The fasting blood glucose (FPG), fasting plasma insulin (FINS), insulin resistance index (HOMA-IR) before treatment and 3 months and 6 months after treatment were compared between the two groups, as well as their cholesterol (TC) and triacyl Glycerin (TG), serum albumin (ALB), blood urea nitrogen (BUN), creatinine (SCr), β2-microglobulin (β2-MG), parathyroid hormone (PTH), hypersensitive C-reactive protein (Hs) -CRP) and other related indicators.

Results

The FINS and HOMA-IR levels of the HFHD+HDF group after 3 and 6 months of treatment were lower than those of the LFHD+HDF group (P<0.05). And the levels of TC, TG, PTH and Hs-CRP in the HFHD+HDF group after 3 and 6 months of treatment were significantly lower than those in the LFHD+HDF group, the difference was statistically significant (P<0.05); the HFHD+HDF group was The levels of TC, TG, PTH and Hs-CRP after 3 and 6 months of treatment were significantly lower than those of the LFHD+HDF group (P<0.05), and the Kt/V levels of the LFHD+HDF group were significantly lower than the treatment for 6 months Before, the Kt/V level of the HFHD+HDF group was significantly higher than that before treatment, and was significantly higher than that of the LFHD+HDF group, the difference was statistically significant (P<0.05).

Conclusions

High-flux hemodialysis combined with hemodiafiltration (HFHD+HDF) compared with low-flux hemodialysis combined with hemodiafiltration (LFHD+HDF) can improve insulin resistance and body lipid metabolism in patients with insulin resistance uremia, and improve renal function.

表1 两组患者一般资料对比
表2 两组患者的血糖和胰岛素抵抗指标比较
表3 两组患者的血脂相关指标比较
表4 两组患者的肾功能相关指标比较
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