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目的前瞻性观察中长期应用血液透析(HD)联合血液灌流(HP)对维持性血液透析患者的血管内皮功能的保护作用。方法选取我院60例维持性血液透析患者共60例,随机分为两组:HD组和HP联合HD(HP+HD)组。所有患者每周血液透析3次,其中,HP+HD组每周1次血液透析联合血液灌流,共治疗6个月。比较治疗前、治疗3个月及治疗6个月的C反应蛋白(CRP)、血红蛋白(HB)、白蛋白(ALB)、胆固醇(CHOL)、甘油三酯(TG)、血清晚期糖基化终产物(AGEs)、同型半胱氨酸(Hcy)、细胞黏附因子(ICAM)浓度。结果治疗6个月后,HP+HD组的CRP、AGEs、Hcy和ICAM水平均较本组治疗前和HD组治疗后降低(P<0.05),HB和ALB均较本组治疗前和HD组增高(P<0.05)。两组治疗前后的CHOL及TG差异无统计学意义。结论中长期应用HD联合HP治疗可有效清除AGEs、Hcy及ICAM,并改善营养状态,为减少维持性血液透析患者心血管疾病的发生率,降低死亡率,提高生活质量,提供了安全、简便、有效的治疗途径。
Objective To prospectively observe the long-term use of hemodialysis (HD) combined with hemoperfusion (HP) in maintenance hemodialysis patients with vascular endothelial function. Methods 60 cases of maintenance hemodialysis patients in our hospital were randomly divided into two groups: HD group and HP combined HD group. All patients were hemodialied three times a week. Among them, hemodialysis combined with hemoperfusion once a week was used in HP + HD group for 6 months. The levels of CRP, HB, ALB, cholesterol (CHOL), triglyceride (TG), serum advanced glycosylation end point Product (AGEs), homocysteine (Hcy), cell adhesion factor (ICAM) concentrations. Results After 6 months of treatment, the levels of CRP, AGEs, Hcy and ICAM in HP + HD group were lower than those before treatment and HD group after treatment (P <0.05) Increased (P <0.05). There was no significant difference in CHOL and TG between the two groups before and after treatment. Conclusion Long-term HD combined with HP treatment can effectively clear AGEs, Hcy and ICAM, and improve nutritional status, in order to reduce the incidence of cardiovascular disease in maintenance hemodialysis patients, reduce mortality and improve quality of life, providing a safe, simple, Effective treatment.