目的探讨高通量血液透析对糖尿病肾病患者预后的影响。方法选取2011年7月至2013年9月就诊于本院的88例糖尿病肾病血液透析患者为研究对象,按随机数表法将其分为高通量组(44例)与低通量组(44例),并分别给予高通量血液透析与低通量血液透析治疗,比较两组患者预后情况,应用荧光光谱法检测两组患者前臂内侧皮肤组织中的晚期糖基化终末产物(advanced glycation end products,AGEs)的水平,分析AGEs水平与糖尿病肾病并发症发生率之间的相关性。结果高通量组患者并发心脑血管疾病的发生率[15.91%(7/44)]显著低于低通量组[25.00%(11/44)](P<0.05);治疗后1年,高通量组患者的生存率[93.18%(41/44)]高于低通量组[81.82%(36/44)],但并无显著性差异(P>0.05);治疗后3年,高通量组患者的生存率[84.09%(37/44)]明显高于低通量组[61.36%(27/44)](P<0.05)。经荧光光谱法检测AGEs水平,两组中心脑血管疾病并发症患者的接受者操作特征曲线(receiver operating characteristic curve,ROC曲线)下面积分别为0.97 nm~2和0.87 nm~2,均高于两组中无心脑血管疾病并发症患者的ROC曲线下面积(0.61 nm~2和0.51 nm~2)。高通量组患者AGEs水平[(6.59±1.22)μg/ml]显著低于低通量组[(11.09±2.38)μg/ml](P<0.05)。结论高通量血液透析可有效降低糖尿病肾病患者并发心脑血管疾病的发生率,提高患者的生存率,保障其远期生存质量;检测AGEs水平对未来糖尿病肾病并发症的发生具有预警作用,并为糖尿病肾病的病情预测及评估提供重要的临床依据。 Objective To investigate the effect of high-flux hemodialysis on the prognosis of patients with diabetic nephropathy. Methods A total of 88 hemodialysis patients with diabetic nephropathy who visited our hospital from July 2011 to September 2013 were enrolled in the study. According to the random number table, they were divided into high-dose group (44 cases) and low-dose group 44 cases) were given high-dose hemodialysis and low-dose hemodialysis respectively. The prognosis of the two groups was compared. Fluorescence spectra were used to detect the advanced glycation end products in the medial forearm forearm glycation end products (AGEs), and to analyze the correlation between the level of AGEs and the incidence of diabetic nephropathy. Results The incidence of cardiovascular and cerebrovascular diseases was significantly lower in high-throughput group (15.91%, 7/44) than in low-dose group (25.00%, 11/44) (P <0.05) The survival rate of high-dose group was higher than that of low-dose group [93.18% (41/44)] [81.82% (36/44)], but there was no significant difference (P> 0.05) The survival rate of high-dose group was significantly higher than that of low-dose group [84.09% (37/44) [61.36% (27/44)] (P <0.05). The area under the receiver operating characteristic curve (ROC curve) of patients with complication of central and cerebrovascular diseases in the two groups was 0.97 nm ~ 2 and 0.87 nm ~ 2, respectively, both of which were higher than two The area under the ROC curve (0.61 nm ~ 2 and 0.51 nm ~ 2) of patients without complications of cardiovascular and cerebrovascular diseases in the group. The level of AGEs in high-dose group [(6.59 ± 1.22) μg / ml] was significantly lower than that in low-dose group [(11.09 ± 2.38) μg / ml] (P <0.05). Conclusion High-throughput hemodialysis can effectively reduce the incidence of cardiovascular and cerebrovascular diseases in patients with diabetic nephropathy, improve the survival rate of patients and ensure its long-term quality of life. Detection of AGEs has an early warning effect on the occurrence of complications of diabetic nephropathy in the future It provides important clinical evidence for the prediction and evaluation of diabetic nephropathy.