单中心不同透析方式对维持性血液透析患者生存质量及经济.DOC

单中心不同透析方式对维持性血液透析患者生存质量及经济 负担的临床分析 冉玉力 吴艳春 谭华 （武警四川总队医院肾内科，614000;电话：0833-2452849邮箱：wjyyran@163.com） 【摘要】 目的 观察不同透析方式对患者生存质量及经济负担的影响。方法 将90例维持性血液透析患者随机分成HD组、HFHD组、HDF组，治疗时间6月，观察3组治疗前后Hb、Alb、P、PTH、β2-Mg、Leptin的变化，采用SF一36量表调查治疗前后健康相关生活质量，同时统计患者家庭总收入、医疗及相关支出情况。结果 治疗前3组患者生化检查、SF36评分、家庭总收入比较，均无统计学差异（P＞0.05）。治疗6月后，HFHD与HDF组治疗后Hb、Alb上升，PO4-3、PTH、β2-Mg、Leptin下降，差异有统计学意义(P＜0.05)，其中HDF疗效更为显著，而HD组与治疗前，比较无差异性（P＞0.05）。HFHD、HDF组治疗后生理健康评分均上升，HDF组社会功能(SF)评分下降，与治疗前比较差异有统计学意义(P＜0.05)。HDF与HD、HFHD组在总医疗费、自付医疗费、个人总支出方面比较有显著差异性（P＜0.05），HD和HFHD比较无差异性（P＞0.05）。结论 高通量血液透析，能提高患者生存质量，效价比高，适合在临床上推广应用。 【关键词】血液透析，高通透量透析，血液透析滤过，生存质量，卫生经济 A Monocenter Clinical Analysis of Different Dialysis Modalities’ Impact on Quality of Life and Cost of Maintenance HD Patients Ran Yuli, Wu Yanchun, Tan Hua Department of Nephrology, Sichuan Corps Hospital of Chinese Armed Police Force 【Abstract】Objective: The aim of the study was to evaluate and analyze the impact of different dialysis modalities on quality of life and cost of patients in Maintenance HD in a single center. Methods: 90 maintenance HD patients were randomly divided into HD group, HFHD group and HDF group with 3 times a week and 4 dialysis-hours per session for 6 months. Compare the parameters of Hb, Alb, P, PTH, β2-MG, leptin, SF-36 scores, and family income and dialysis related health care cost between at the baseline and after 6-month trial. Results: At the baseline there were no significant differences in blood chemistry, SF-36 scores and family income among the three groups (P0.05). At the end of the 6-month trial, Hb and Alb level increased significantly while PO4-3, PTH, β2-MG and leptin decreased significantly in HFHD and HDF groups (P0.05). HDF group improved much more significantly. HD group showed no significant changes to baseline (P0.05). Physical component scores were significantly improved in HFHD and HDF groups while social functioning scores d