五种血液净化手段单次治疗对肾衰竭患者血磷的影响  

Effects of Monotherapy by Five Kinds of Blood Purification Modes on the Blood Phosphorus of Renal Failure Patients

作　　者：李洪[1] 曾丽花[1] 吴红兰[1] 卢飞杏[1] 陈业珍[1] 林芳[1] 苏庆玲[1] 欧阳陪花[1] 曾欣[1] 

机构地区：[1]海南省人民医院血液净化中心,海口570311

出　　处：《中国中西医结合肾病杂志》2007年第7期394-397,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：本课题为海南省自然科学基金资助项目(No.80456)

摘　　要：目的:了解常规间歇性血透(IHD)、IHD串联活性炭吸附器YTS-200、IHD串联树脂吸附器HA-330、持续缓慢低效血液透析(SLED)、日间持续性静脉-静脉血液滤过(CVVH)5种治疗模式对急慢性肾衰竭患者血磷的清除情况。方法:慢性维持性血透患者30例交叉行IHDI、HD+YTS-200I、HD+HA-330治疗;20例危重急慢性肾衰竭患者交叉行SLED、CVVH治疗。治疗前后检查血磷和血尿素,计算其下降率,比较治疗模式对其影响。结果:上5种治疗模式对肾衰竭患者血磷均有明显的清除,磷下降率(P-RR):IHD 41.16±13.774I、HD+YTS-200 50.236±10.968I、HD+HA-33045.67±17.05、SLED 54.12±17.277、CVVH为28.06±22.71;秩和检验示SLED与IHD+YTS-200治疗之间无差异,IHD与IHD+HA-330治疗之间无差异(P>0.05),其余的模式间比较均有统计学差异(P<0.05)。BUN下降率(URR):IHD77.39±5.38I、HD+YTS-200 74.82±6.36I、HD+HA-330 73.80±5.45、SLED 80.59±9.9、CVVH 43.66±18.19;配对T检验示同一治疗URR明显高于P-RR(P<0.05)。结论:IHDI、HD+YTS-200I、HD+HA-330、SLED、日间CVVH5种治疗模式对肾衰竭患者血磷的清除不同于BUN,每次每种治疗P-RR明显小于URR;YTS-200吸附器对血磷有显著的吸附效果;IHD+YTS-200、SLED治疗对血磷的清除效果类似,显著高于其他3种血液净化模式;SLED的P-RR显著高于相同时间日间CVVH(10 h);SLED对高血磷治疗有高性价比优势。Objective：To study the blood phosphorus clearance during conventional intermittent hemodialysis （IHD）, IHD conjugated hemoperfusion with active carbon absorb column, IHD conjugated hemoperfusion with resin column, continuous low - ef- ficiency dialysis（SLED）, daily continuous veno- venous hemofiltration （CVVH）. Methods;Thirty of chronic maintaining hemodial- ysis patients underwent IHD, IHD ＋ YTS- 200 and IHD ＋ HA- 330 in a crossover way. Twenty of severe acute/chronic renal fail- tare patients underwent SLED and daily CVVH in crossover way. Blood phosphorus and urea nitrogen were examined, their reduction rates were calculated and the treatment mode influences were compared. Results-Five therapeutic modes had significant blood phosphorus clearance. The phosphorus reduction rates （P- RR） were： IHD 41.16 ± 13. 774, IHD ＋ YTS- 200： 50. 236 ± 10. 968, IHD ＋ HA- 330 ： 45.67 ± 17.05, SLED： 54.12 ± 17. 277 and CRRT： 28.06 ± 22.71 ; Wilcoxon analysis showed that there were no significant differences between P- RR of SLED and IHD ＋ YTS - 200, or between P - RR of IHD and IHD ＋ HA - 200 （ P 〉 0.05）. The other therapy modes had significant differences in between groups （P 〈 0.05）. Serum urea reduction rate （URR） ： IHD 77.39 ± 5.38, IHD ＋ YTS- 200 74.82 ± 6.36, IHD ＋ HA- 330 73.80 ± 5.45, SLED 80.59 ± 9.9 and CRRT 43.66 ± 18.19. Paired t - test showed that there were significant differences between URR and P- RR in same kind of therapy mode （P〈0.05）.Conclusion： IHD, IHD＋ YTS- 200, IHD ＋ HA- 330, SLED and daily CVVH removes blood phosphorus in a manner different from BUN. P- RR was significant lower than URR in eaeh mode. YTS- 200 column had significant adsorbanee effect on blood phosphorus. IHD ＋ YTS- 200, SLED had same P- RR and significant higher than the other three kinds modes. P- RR of SLED was significant higher than same duration of daily VH. SLED had significant advantage of higher quality/priee ratio for hyperphosphaternia treatme

关 键 词：血液净化 单次治疗 肾衰竭 血磷 

分 类 号：R692.5[医药卫生—泌尿科学]