| 李晖云 于磊 刘艾芹 张德鱼 王春艳 杨书彦 刘国平 包春春.不同透析方式治疗终末期糖尿病肾病临床疗效比较[J].现代生物医学进展英文版,2014,14(22):4294-4297. |
| 不同透析方式治疗终末期糖尿病肾病临床疗效比较 |
| Clinical Curative Comparison between Two Ways of Dialysis Treatment ofPatient with end-stage Diabetic Nephropathy |
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| DOI： |
| 中文关键词: 糖尿病肾病 血液透析 腹膜透析 透析疗法 |
| 英文关键词: Diabetic nephropathy Hemodialysis Peritoneal dialysis Dialysis therapy |
| 基金项目:内蒙古自治区自然科学基金资助项目（2010BS1102） |
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| 中文摘要: |
| 目的：比较应用血液透析(hemodialysis, HD)与持续不卧床腹膜透析(continuous ambulatory peritoneal dialysis, CAPD)两种不
同透析方式治疗终末期糖尿病肾病的临床疗效。方法：回顾性分析2010 年6月至2013 年2 月在我院接受透析治疗的终末期糖尿
病肾病患者98 例的临床资料,其中55 例为接受HD 治疗，43 例接受CAPD 治疗，统计分析及比较两组的临床治疗效果。结果：
HD 组透析后的体重（50.2± 8.9Kg）较透析前（58.4± 10.1Kg）明显减轻（P<0.05），也明显低于CAPD 组透析后体重(60.4± 9.1 kg)
（P<0.05）, HD 组透析后血压下降明显(SBP 157.6± 20.2 vs 144.3± 14.4 mmHg, DBP 71.4± 12.9 vs 83.2± 10.9 mmHg)（P<0.05）,同
时明显低于CAPD 组透析后血压（SBP 144.3± 14.4 mmHg vs 159.4± 17.1 mmHg, DBP 71.4± 12.9 vs 84.3± 10.5 mmHg)（P<0.05），
两组透析后尿量与透析前比较无明显差异（>0.05），但HD组尿量(487.0± 332.0 mL)明显少于CAPD 组(593.0± 420.0 ml)（P<0.05），
两组透析后生化指标如肌酐(HD 310.6± 210.1 滋mol/L，CAPD425.9± 267.2 滋mol/L)、尿素氮(HD 11.6± 4.1 mmol/L, CAPD 19.5±
6.9 mmol/L)、血钾(HD 3.4± 0.4 mmol/L, CAPD 3.6± 0.5 mmol/L)有明显下降（P<0.05），HD 组透析后血浆总蛋白(59.4± 8.1 g/L)及
白蛋白(37.4± 6.1 g/L)水平较透析前(TP 55.2± 9.0 g/L, ALB 33.2± 5.9 g/L)显著性升高(P＜0.05)，且HD 组血浆总蛋白(55.2± 9.0
g/L)及白蛋白水平(33.2± 5.9 g/L)显著高于CAPD 组（TP 52.5± 7.3 g/L, ALB 33.4± 5.1 g/L）(P＜0.05)，HD 组发生心血管并发症
(36.3%)、出血事件(30.9%)的比例较CAPD 组(16.2%,13.9%)升高，差异具有统计学意义(P＜0.05)。结论：两种透析方式都是治疗终
末期糖尿病肾病的有效措施,两者各有特点。对于不同病人应采取个体化方针，能够提高患者的生活质量，减少并发症及改善预
后。 |
| 英文摘要: |
| Objective:To discuss and compare the clinical curative effect of application of hemodialysis (HD) and continuous
ambulatory peritoneal dialysis (CAPD) on patients with terminal-stage diabetic nephropathy.Methods:A retrospective review was
conducted on the data of 98 patients with terminal-stage diabetic nephropathy who underwent dialysis therapy in our hospital between
June 2010 and February 2013. Among them, 55 had HD treatment and the other 43 received CAPD. The clinical therapeutic effect of the
two therapies were analyzed and compared between the two groups.Results:The patients in HD group had their weights（50.2± 8.9 Kg）
down significantly after dialysis（58.4± 10.1 Kg）(P<0.05) and had less weight after dialysis than that in the CAPD group (60.4± 9.1 kg)
(P<0.05). The blood pressure of the patients in HD group greatly declined after dialysis (SBP 157.6± 20.2 mmHg vs 144.3± 14.4 mmHg,
DBP71.4± 12.9 mmHg vs 83.2± 10.9 mmHg) (P<0.05) and was lower than that of patients in CAPD group after dialysis（SBP 144.3±
14.4 mmHg vs 159.4± 17.1 mmHg, DBP 71.4± 12.9 mmHg vs 84.3± 10.5 mmHg) (P<0.05). The urine volume of the two groups after
dialysis were similar with that before dialysis, but patients in HD group had less urine volume (487.0± 332.0 ml) than those in CAPD
group (593.0± 420.0 ml) after dialysis (P<0.05). The biochemical indicators such as creatinine (HD 310.6± 210.1 滋mol/L, CAPD
425.9± 267.2 滋mol/L), urea nitrogen (HD 11.6± 4.1 mmol/L, CAPD 19.5± 6.9 mmol/L), potassium (HD 3.4± 0.4mmol/L, CAPD 3.6±
0.5 mmol/L) after dialysis were significantly lower than those before dialysis (P<0.05). The level of plasma total protein (59.4± 8.1 g/L)
and plasma albumin (37.4± 6.1 g/L) of patients in HD group after dialysis were significantly higher than those before dialysis(TP 55.2±
9.0 g/L, ALB 33.2± 5.9 g/L) (P<0.05), and the two levels after dialysis in HD group (TP 55.2± 9.0 g/L, ALB 33.2± 5.9g/L) were also
significantly higher than that in CAPD group (TP 52.5 ± 7.3g/L, ALB 33.4 ± 5.1 g/L）(P<0.05). The incidences of cardiovascular
complications (36.3%) and bleeding (30.9%) in HD patients were higher than in CAPD patients (16.2%and 13.9%, respectively)(P＜
0.05).Conclusion:Both dialysis methods were effective measures to treat patients with terminal-stage diabetic nephropathy and had their
own characteristics. We can improve the quality of life of patients, reduce incidence of complications and promote prognosis by means of
individualized principle for different patients. |
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