目的 探讨糖尿病肾病维持性血液透析（MHD）患者应用不同频率血液透析滤过（HDF）联合高通量血液透析（HFHD）治疗对肾功能、微炎症状态及左心功能的影响。 方法 选取2022年1月至2024年12月120例糖尿病肾病MHD患者，以随机数字表法分为观察组（n = 60）及对照组（n = 60）。两组均行HFHD治疗，对照组予以HDF治疗1次/月，观察组予以HDF治疗1次/周。比较两组疗效、肾功能指标、钙磷代谢指标、微炎症状态、左心功能指标、不良反应。 结果 观察组较对照组总有效率升高（P < 0.05）；治疗后，观察组血肌酐（Scr）、胱抑素（Cys C）、24 h尿蛋白定量（24 hUP）低于对照组（P < 0.05）；治疗后，观察组血钙高于对照组，血磷低于对照组（P < 0.05）；治疗后，观察组白细胞介素-8（IL-8）、IL-6、肿瘤坏死因子-α（TNF-α）低于对照组（P < 0.05）；治疗后，观察组左室射血分数（LVEF）高于对照组，左室舒张末期内径（LVDD）及左室收缩末期内径（LVSD）低于对照组（P < 0.05）；观察组及对照组不良反应率分别为8.33%（5/60）、11.67%（7/60），差异无统计学意义（P > 0.05）。 结论 每周1次HDF联合HFHD治疗能提高糖尿病肾病MHD的疗效，改善患者肾功能，促进钙磷代谢恢复，减轻微炎症状态，提高左心功能。

Objective To investigate the effects of different hemodiafiltration （HDF） frequencies combined with high-flux hemodialysis （HFHD） on renal function， micro-inflammatory status， and left ventricular function in patients with diabetic nephropathy who have undergone maintenance hemodialysis （MHD）. Methods A total of 120 patients with diabetic nephropathy undergoing MHD between January 2022 and December 2024 were enrolled in the study and randomly divided into a study group and a control group using a random number table method， with 60 patients in each group. Both groups received HFHD. The control group received hemodiafiltration （HDF） once a month， whereas the study group received HDF once a week. The study evaluated the two groups in terms of therapeutic efficacy， renal function indices， calcium-phosphorus metabolism indices， micro-inflammatory status， left ventricular function indices， and the incidence of adverse reactions. Results The total response rate in the study group was significantly higher than that in the control group （P < 0.05）. Following treatment， the levels of serum creatinine （Scr）， cystatin C （Cys C）， and 24-hour urine protein quantification （24hUP） in the study group were significantly lower than those in the control group （P < 0.05）. After treatment， the blood calcium level in the study group was higher， whereas the blood phosphorus level was lower compared to the control group （P < 0.05）. Additionally， post-treatment levels of interleukin-8 （IL-8）， IL-6， and tumor necrosis factor-α （TNF-α） in the study group were significantly reduced in comparison to the control group （P < 0.05）. The study group also exhibited improved cardiac function after treatment， as evidenced by a higher left ventricular ejection fraction （LVEF）， and reduced left ventricular end-diastolic diameter （LVDD） and left ventricular end-systolic diameter （LVSD） compared to the control group （P < 0.05）. There was no statistically significant difference in the incidence of adverse reactions between the two groups ［8.33% （5/60） vs. 11.67% （7/60）， P > 0.05］. Conclusion Combining once-weekly HDF with HFHD can enhance therapeutic outcomes and renal function， promote the recovery of calcium-phosphorus metabolism， alleviate the micro-inflammatory state， and improve left ventricular function in MHD patients with diabetic nephropathy.