高通量透析对维持性血液透析患者颈动脉粥样硬化的影响  

Effects of high permeable hemodialysis on carotid atherosclerosis in patients with maintenance hemodialysis

作　　者：董婧[1] 张江淮[1] 肖蓓[1] 

机构地区：[1]安徽医科大学第三附属医院(合肥市第一人民医院)肾脏内科,合肥230061

出　　处：《安徽医学》2013年第10期1462-1464,共3页Anhui Medical Journal

摘　　要：目的探讨高通量血液透析(high permeable hemodialysis,HPD)对维持性血液透析(maintenance hemodialysis,MHD)患者颈动脉粥样硬化的影响及机制。方法维持性血液透析的患者60例,高通量透析组(HPD组)和普通透析组(LPD组)各30例。HPD组采用费森尤斯公司FX60高通量透析器,LPD组采用费森尤斯公司F7透析器。两组患者每周透析时间均为12 h。治疗时间6个月,观察两组患者治疗前后血压、血脂、甲状旁腺激素(parathyroid hormone,PTH)及钙磷乘积、颈总动脉内膜-中层厚度(intima medial thickness,IMT)。结果治疗6个月后,LPD组收缩压、平均动脉压、三酰甘油、钙磷乘积和PTH指标与透析前相比差异无统计学意义(P>0.05)。与LPD组相比,HPD组收缩压和平均动脉压明显降低,三酰甘油水平和IMT值低于LPD组(P<0.05),颈总动脉IMT低于LDP组(P<0.05),但两组患者钙磷乘积和PTH差异无统计学意义(P>0.05)。结论高通量透析模式可以延缓维持性血液透析患者颈动脉粥样硬化进展,其对血压和血脂的影响可能是其中机制。Objective To observe the effect of high permeable hemodialysis(HPD) on carotid atherosclerosis in patients with maintenance hemodialysis and its mechanisms. Methods Totally 60 patients with maintenance hemodialysis were randomly divided into two groups: 30 cases were treated with HPD using F60 dialyser( HPD group),and the other 30 cases were treated with low permeable hemodialysis( LPD) using F7 dialyser( LPD group). Their mean artery pressure,triglyceride,calcium- phosphorus product,parathyroid hormone(PTH),and intima medial thickness(IMT) were observed before and after six months' treatment. Results After the dialysis for six months,blood pressure,triglyceride,calcium- phosphorus product,PTH and IMT in LPD group remained unchanged. Systolic pressure,mean arterial pressure,triglyceride levels and carotid IMT were significantly lower in HPD group than those in LPD group( P < 0. 05),but the changes of calcium- phosphorus product and PTH levels did not reach statistical significance(P >0. 05). Conclusion HPD is effective in improving hypertension and triglyceride in hemodialysis patients,which may be helpful to delay the progression of carotid atherosclerosis.

关 键 词：高通量血液透析 维持性血液透析 颈总动脉内膜-中层厚度 

分 类 号：R692.5[医药卫生—泌尿科学] R543.4[医药卫生—外科学]