李小卿

[摘要]目的探討不同血液透析滤过频率对维持性血液透析（MHD）患者贫血疗效及生活质量的影响。方法选择2019年1月至2020年12月到梧州市红十字会医院血液透析室进行维持性血液透析患者120例，按不同透析滤过频率分为四组， A 组为常规血液透析30例， B 组每周1次透析滤过30例， C 组每2周1次透析滤过30例， D 组每4周1次透析滤过30例。每月遵医嘱调整促红细胞生成素（EPO）用量。评价治疗前和治疗后6个月患者的血红蛋白（Hb）、白蛋白（Alb）、促红细胞生成素（EPO）用量与红细胞比容（Hct）比值（EPO/Hct），C-反应蛋白（CRP）、甲状旁腺激素（PTH）、微炎症指标及各项生活质量评分。结果在治疗效果上， A 组患者 Hb、Alb、PTH、EPO 用量较治疗前有所上升， EPO/Hct、CRP 有所下降，但差异均无统计学意义（P >0.05）;B、C、D 组患者 Hb、Alb 水平均高于治疗前， CRP、PTH、EPO/Hct、EPO 用量水平低于治疗前，差异有统计学意义（ P <0.05），组间比较 B、C 组差异有统计学意义。在生活质量评分上， A 组患者前后生活质量评分8个项目上比较差异有统计学意义（P <0.05），B、C、D 组在社会功能、情感职能、心理健康方面得分比较，差异无统计学意义（P >0.05），其他5个项目差异有统计学意义（ P <0.05）。结论不同频率血液透析滤过能有效改善患者肾性贫血，提高患者的疗效及生活质量。

[关键词]不同频率;血液透析滤过;血液透析;肾性贫血;疗效

[中图分类号] R692.5  [文献标识码] A   [文章编号]2095-0616（2022）09-0196-05

Effects of different hemodialysis filtration frequencies on the efficacy for anemia and QoL in MHD patients

LI  Xiaoqing

Hemodialysis Unit， Wuzhou Red Cross Hospital， Guangxi， Wuzhou 543002， China

[Abstract] Objective To investigate the effects of different hemodialysis filtration frequencies on the efficacy for anemia and quality of life （QOL） in patients with maintenance hemodialysis （MHD）. Methods A total of 120 patients undergoing MHD in the Hemodialysis Unit of Wuzhou Red Cross Hospital from January 2019 to December 2020 were selected as study subjects， and they were divided into group A （n=30， receiving conventional hemodialysis）， group B （n=30， receiving dialysis filtration once a week）， group C （n=30， receiving dialysis filtration once every 2 weeks）， and group D （n=30， receiving dialysis filtration once every 4 weeks） according to different dialysis filtration frequencies. The dosage of erythropoietin （EPO） was adjusted monthly as prescribed by the doctor. The hemoglobin （Hb）， albumin （Alb）， the ratio of EPO dosage to hematocrit （Hct）（EPO/Hct）， C-reactive protein （CRP）， parathyroid hormone （PTH）， microinflammatory indexes and QoL scores of various items were evaluated before and 6 months after treatment. Results In terms of efficacy， the Hb， Alb and PTH levels and EPO dosage were higher， while the EPO/Hct value and CRP level were lower in group A after treatment than those before treatment， with no statistically significant differences （P >0.05）. Meanwhile， the Hb and Alb levels were higher， while the CRP and PTH levels， EPO/Hct value， and EPO dosage were lower in groups B， C， and D after treatment than those before treatment， and the differences were statistically significant （P <0.05）， with the most significant differences between groups B and C. In terms of QOL scores， the before-after study in the same patients revealed that there were statistically significant differences in QOL scores on eight items in group A （P <0.05）. At the same time， there were no statistically significant differences in scores of social functioning， role-emotional， and mental health among groups B， C， and D （P >0.05）， while statistically significant differences were found in the other five items （P <0.05）. Conclusion Different frequencies of hemodialysis filtration can effectively improve renal anemia as well as improve the efficacy and QOL of patients.

[Key words] Different frequencies; Hemodialysis filtration; Hemodialysis; Renal anemia; Efficacy 196   CHINA MEDICINE AND PHARMACY  Vol.12 No.9  May 2022

肾性贫血是慢性肾脏病（chronic kidney disease， CKD）需行维持性血液透析（maintenance hemodialysis， MHD）患者的常见并发症之一，其发生率随着 CKD 患者肾功能减退而逐步增高，中期 CKD 3期患者近半数会并发肾性贫血（45.4%），而到终末期 CKD 5期时发生率高达98.2%，严重影响患者的生存率和生活质量[1-2]。……