双罐串联连续血液净化对慢性肾衰竭尿毒症患者血清可溶性转铁蛋白受体和人巨噬细胞趋化蛋白-1水平及生存质量的影响OACSTPCD

Objective:To investigate the effect of continuous renal replacement therapy(CRRT)by series double tank on serum soluble transferrin receptor(sTfR),human macrophage chemotactic protein-1(MCP-1)level and survival quality in uremic patients with chronic renal failure.Methods:A total of 96 uremia patients with chronic renal failure underwent hemodialysis in the First Affiliated Hospital of Xinjiang Medical University from April 2022 to April 2023 were selected,and they were randomly divided into single tank group(single tank of CRRT continuous blood purification)and series double tank group(series double tank of CRRT continuous blood purification),with 48 patients in each group.The serum sTfR and MCP-1 levels of patients in two groups were measured before treatment,and 2 months,half a year and 1 year after treatment,and the relieved degree of skin pruritus after treatment was judged.The white blood cell(WBC)levels and the scores of acute physiological and chronic health evaluation II(APACHEII)scale of two groups were recorded before and 72h after treatment,respectively.The Chinese version of the European Five Dimension Scale(CEQ-5D-3L)was used to assess the quality of life of patients before and after treatment.Results:There was no significant difference in serum sTfR levels between the two groups(P>0.05).At 2 months,half a year and 1 year after treatment,the serum sTfR levels in the series double tank group were respectively lower than those of the single tank group,with statistically significant differences(t=5.089,18.410,41.306,P<0.05).There was no significant difference in serum MCP-1 level before treatment between two groups(P>0.05).At 2 months,half a year and 1 year after treatment,the MCP-1 levels in the series double tank group were respectively lower those in the single tank group,with statistically significant differences(t=8.554,8.019,10.744,P<0.05).The degree of existing skin pruritus of two groups were improved after treatment,however,the relieved degree of the single tank group was significantly lower than that of the series double tank group,with statistically significant difference(x2=8.540,P<0.05).The differences of WBC and APACHEII scores before treatment between the two groups were not statistically significant(P>0.05).At 72h after treatment,the WBC and APACHEII scores of two groups decreased,and the improvement degrees of them of the series double tank group were better than those of the single tank group,with statistically significant differences(t=5.549,14.781,P<0.05).The difference of serum CEQ-5D-3L scores before treatment between the two groups was not significant(P>0.05).At each time point of 2 months,half a year and 1 year after treatment,the total scores of the health description system standard of the series double tank group were significantly lower than those of the single tank group,and the visual analogue scale(VAS)scores of the series double tank group were significantly higher than those of the single tank group(t the total score of t he health description system standard=4.744,5.103,9.418,t VAS score=3.375,2.866,3.126,P<0.05),respectively.Conclusion:The series double tank CRRT can effectively reduce the serum sTfR and MCP-1 levels in uremia patients with chronic renal failure,and relieve the skin pruritus,and improve the survival quality,and effectively reduce the WBC level,and improve APACHEII score and blood routine.