中国实用内科杂志2024，Vol.44Issue(12)：1032-1038,7.DOI:10.19538/j.nk2024120112
血液灌流联合血液透析和单纯血液透析对患者皮肤瘙痒疗效的比较研究
Study on the effect of hemoperfusion combined with hemodialysis compared with that of hemodialysis alone on patients with uremic pruritus
摘要
Abstract
Objective To compare the effect of hemoperfusion combined with hemodialysis on relieving uremic pruritus withthat of hemodialysis alone in dialysis patients.Methods The clinical data of 60 patients with uremic pruritus were retrospectively analyzed,who received regular hemodialysis in the Department of Nephrology of China Medical University from Jan.2022 to Jan.2024,and they were divided into a hemodialysis group(HD group,no hemoperfusion,30 cases)and a hemoperfusion group(HP+HD group,hemoperfusion≥ 1 time/month,30 cases)based on whether they received hemoperfusion during the follow-up.Compare and observe the changes in serum urea nitrogen(BUN),creatinine(SCr),calcium,phosphorus,intact parathyroid hormone(iPTH),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)at the starting point and after 6 months of dialysis treatment,and evaluate the relief of uremic pruritus in patients through changes in visual analog scale(VAS)scores.Results After 6 months of treatment with two dialysis methods,the HP+HD group showed a significantly higher effective rate in relieving uremic pruritus(90.00％)than the HD group(53.33％),with a statistically significant difference(P＜0.05).The VAS scores of the HP+HD group[3(3,5)]were lower than those of the HD group[4.5(4,6)],and the difference was statistically significant(P＜0.05).There was no significant difference in serum BUN,SCr,calcium,or phosphorus between the two groups of patients(P＞0.05),but the iPTH level in the HP+HD group[(52.83±8.24)pmol/L]was lower than that in the HD group[(59.77±8.81)pmol/L],the CRP level in the HP+HD group[(8.61±2.74)mg/L]was lower than that in the HD group[(10.35±3.11)mg/L],the TNF-αlevel in the HP+HD group[(12.41±3.16)ng/L]was lower than that in the HD group[(14.21±4.72)ng/L],and the IL-6 level in the HP+HD group[(11.16±3.30)ng/L]was lower than that in the HD group[(14.28±5.59)ng/L],all the differences being statistically significant(P＜0.05).The correlation analysis results showed that the VAS score for uremic pruritus was positively correlated with CRP level,TNF-α level and iPTH level respectively.Conclusion Compared with hemodialysis alone,the combination of hemodialysis with hemoperfusion can better eliminate iPTH and inflammatory factors(CRP,TNF-α,IL-6),thereby effectively relieving uremic pruritus in dialysis patients.It is an effective measure for treating uremic pruritus in maintenance HD patients.关键词
血液灌流/血液透析/皮肤瘙痒/全段甲状旁腺激素/炎症因子Key words
hemoperfusion/hemodialysis/chronic kidney disease associateel pruritus/intact parathyroid hormone/inflammatory factors分类
医药卫生引用本文复制引用
李悦,曲巍,秦丽丽,郑晓庆,杜银科,姚丽..血液灌流联合血液透析和单纯血液透析对患者皮肤瘙痒疗效的比较研究[J].中国实用内科杂志,2024,44(12):1032-1038,7.基金项目
辽宁省中央引导地方科技发展资金计划项目(2024JH6/100800028) （2024JH6/100800028）
