赵东

[摘要] 目的 探討高通量血液透析在终末期肾病（ESRD）中的应用效果。 方法 选择2018年2月至2020年2月在我院行血液透析治疗的80例ESRD患者进行回顾性分析，按照治疗方式的不同分为对照组与观察组，每组各40例，其中对照组患者采用常规血液透析治疗，观察组患者则采用高通量血液透析治疗，对比两组患者治疗前后的血清毒素水平、炎症因子水平以及心功能指标。 结果 观察组在治疗后的β2微球蛋白（β2-MG）及甲状旁腺激素（PTH）指标明显低于对照组，差异有统计学意义（P<0.05）;且治疗后观察组的白介素-6（IL-6）、白介素-18（IL-18）、肿瘤坏死因子（TNF-α）水平也显著低于对照组，差异有统计学意义（P<0.05）;此外，治疗后观察组的每搏输出量（SV）、左心室射血分数（LVEF）均明显高于对照组，差异有统计学意义（P<0.05），而舒张期左室内径（LVEDD）及收缩期左室内径（LVESD）则明显低于对照组，差异有统计学意义（P<0.05）。 结论 高通量血液透析对ESRD患者炎症反应及心肌功能的改善均具有显著的应用效果。

[关键词] 高通量血液透析;终末期肾病;心功能;大分子血清毒素

[中图分类号] R459.5          [文献标识码] B          [文章编号] 1673-9701（2021）11-0044-04

Effect of high-flux hemodialysis on end-stage renal disease and its influence on cardiac function

ZHAO Dong

Department of Nephrology， the People′s Hospital of Macheng City in Hubei Province， Macheng   438300， China

[Abstract] Objective To explore the application effect of high-flux hemodialysis in end-stage renal disease （ESRD）. Methods A total of 80 patients with ESRD who underwent hemodialysis in our hospital from February 2018 to February 2020 were analyzed retrospectively. According to different treatment methods， they were divided into the control group and the observation group， with 40 cases in each group. Patients in the control group were treated with routine hemodialysis， while patients in the observation group were treated with high-flux hemodialysis. The levels of serum toxins， inflammatory factors and cardiac function indexes were compared between the two groups before and after treatment. Results After treatment， β2-microglobulin （β2-MG） and parathyroid hormone（PTH） in the observation group were significantly lower than those in the control group，with significant difference （P<0.05）. The levels of interleukin-6（IL-6）， interleukin-18（IL-18） and tumor necrosis factor （TNF-α） in the observation group after treatment were also significantly lower than those in the control group，with significant difference （P<0.05）. In addition， the stroke volume （SV） and left ventricular ejection fraction（LVEF） in the observation group after treatment were significantly higher than those in the control group，with significant difference （P<0.05）， while the diastolic left ventricular diameter （LVEDD） and systolic left ventricular diameter（LVESD） in the observation group were significantly lower than those in the control groupwith significant difference（P<0.05）. Conclusion High-flux hemodialysis has a significant application effect on the improvement of inflammatory reaction and myocardial function in ESRD patients.

[Key words] High-flux hemodialysis; End-stage renal disease; Heart function; Macromolecular toxin

终末期肾病（End-stage renal disease，ESRD）是指各种慢性肾脏疾病的终末期阶段，通常具有病情重、不可逆转等临床特点，且随着肾功能的进行性下降，其毒素可在体内进一步蓄积，从而引起各种并发症的出现[1]，危及患者生命健康。血液透析（Hemodialysis，HD）是临床较为常见的肾脏替代疗法，可借助体外设备，利用溶质由高浓度向低浓度弥散的特质发挥其代谢及净化作用，以清除血液毒素[2]，达到缓解症状的目的，已成为ESRD患者延续其生存时间的重要方式。但在实际治疗中，常规透析所用的低通量透析器通常无法有效清除患者的大、中分子毒素，因此在经过长期的血液透析治疗后，患者仍伴有较高的并发症发生风险[3]。对此，临床认为将高通量血液透析（High flux hemodialysis，HFHD）的治疗方案应用于ESRD患者的治疗中，可显著改善此类状况。现本研究选取2018年2月至2020年2月我院行血液透析治疗的80例ESRD患者，对HFHD的应用效果进行探讨与分析，现报道如下。……