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目的比较血液灌流(HP)联合血液透析(HD)与单纯应用HD治疗尿毒症的疗效。方法将46例维持性HD患者随机分为二组,对照组22例,单纯应用HD治疗。观察组24例,在HD治疗的基础上加用HP,观察临床症状改善情况及治疗前、治疗后3个月检测血尿素氮(BUN)、肌酐(Cr)、甲状旁腺激素(PTH)、C反应蛋白(CRP)。结果观察组临床症状改善优于对照组(P<0.05),观察组PTH、CRP较治疗前明显降低:对照组PTH、CRP无明显变化。组间比较差异具有统计学意义(P<0.05);二种方法在清除BUN、Cr方面差异无统计学意义(P>0.05)。结论 HP联合HD治疗能更好的清除体内PTH等中分子物质,改善微炎症状态,临床症状改善效果优于HD。
Objective To compare the therapeutic effects of hemoperfusion (HP) combined with hemodialysis (HD) and simple HD in the treatment of uremia. Methods 46 cases of maintenance HD were randomly divided into two groups, the control group of 22 cases, the simple application of HD treatment. In the observation group, 24 cases were treated with HP on the basis of HD treatment. The improvement of clinical symptoms and the changes of blood urea nitrogen (BUN), creatinine (Cr), parathyroid hormone (PTH) C-reactive protein (CRP). Results The improvement of clinical symptoms in the observation group was better than that in the control group (P <0.05). The PTH and CRP in the observation group were significantly lower than those before treatment: there was no significant change in the PTH and CRP in the control group. The differences between the two groups were statistically significant (P <0.05). There was no significant difference between the two methods in the clearance of BUN and Cr (P> 0.05). Conclusions HP combined with HD treatment can better remove intermediate substances such as PTH and improve the status of micro-inflammation. The improvement of clinical symptoms is better than that of HD.