贵州医科大学学报

2020, v.45;No.240(09) 1107-1110+1116

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高通量血液透析治疗维持血透终末期肾病患者的临床效果
Clinical Effect of High Flux Hemodialysis on Maintenance Hemodialysis End-Stage Renal Disease

加妮娅,于立丽,齐美晶
JIA Niya,YU Lili,QI Meijing

摘要(Abstract):

目的:探讨高能量血液透析(HFHD)治疗维持血透终末期肾病(ESRD)患者的临床疗效。方法:84例ESRD患者均分为HFHD组和常规血液透析(HD)组,收集2组患者的一般资料和并发症发生情况;于治疗前和治疗6个月时取2组患者空腹静脉血,采用放射免疫法检测血清肌酐(SCr)、血尿素氮(BUN)、血磷(P3+)、血钾(K+)、血清白蛋白(ALB)、血清全段甲状旁腺激素(i PTH)、β2-微球蛋白(β2-MG)及同型半胱氨酸(Hcy)水平。结果:与治疗前比较,2组患者治疗后血清SCr、BUN、P3+、K+、i PTH、β2-MG及Hcy水平均下降(P <0. 05),但HFHD组治疗后血清ALB升高、常规HD组ALB降低(P <0. 05); HFHD组患者治疗后血清i PTH、β2-MG及Hcy均低于常规HD组(P <0. 05); 2组患者HD治疗期间均无死亡病例,HFHD组患者心血管病变和关节病变发生率分别低于常规HD组,低血压发生率则高于常规HD组(P <0. 05)。结论:HFHD清除ESRD患者血清i PTH、β2-MG及Hcy的效果优于常规HD,可降低心血管病变、腕管综合征发生风险,但需注意低血压的发生。
Objective: To investigate the clinical effect of high flux hemodialysis( HFHD) on patients with end stage renal disease( ESRD). Methods: 84 patients with ESRD were divided into HFHD group and HD group,with 42 cases in each group. The general data and complications of the two groups were collected and compared. 10 m L of fasting venous blood before and 6 months after treatment were taken from two groups,then the levels of serum creatinine( SCR),blood urea nitrogen( BUN),blood phosphorus( P3 +,K+,ALB),whole parathyroid hormone( i PTH),β2-microglobulin( β2-MG) and homocysteine( Hcy) were measured by radioimmunoassay. Results: The level of Alb in HFHD group increased significantly( P < 0. 05),while the level of Alb in conventional HD group decreased significantly( P < 0. 05). There was a significant difference between the two groups( P <0. 05). The clearance effect of medium and large molecular substances( i PTH,β2-MG,Hcy) in HFHD group was better than that in conventional HD group( P < 0. 05). The incidence of cardiovascular disease and carpal tunnel syndrome in HFHD group was lower than that in conventional HD group,but the incidence of hypotension was significantly higher( P < 0. 05). Conclusion: The effect of HFHD to remove IPH,β2-MG,and Hcy from ESRD patients is better than that of conventional HD. It can reduce the risk of cardiovascular disease and carpal tunnel syndrome,but the occurrence of hypotension must be avoided during treatment.

关键词(KeyWords): 血液透析滤过;终末期肾病;高通量血液透析;常规血液透析;毒素物质;清除作用;并发症
hemodiafiltration;end stage renal disease(ESRD);high flux hemodialysis(HFHD);conventional hemodialysis(HD);toxic substances;clearance;complications

Abstract:

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作者(Author): 加妮娅,于立丽,齐美晶
JIA Niya,YU Lili,QI Meijing

DOI: 10.19367/j.cnki.2096-8388.2020.09.023

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