不同透析膜和不同透析模式对血液透析患者血浆同型半胱氨酸的影响  

The effect of different dialysers and different dialysis patterns on the plasma homocystine concentrated in hemodialysis patients

作　　者：路建饶[1] 田军[2] 武立群[1] 顾波[1] 王汉清[1] 易阳[1] 药小萍[1] 张金元[2] 

机构地区：[1]上海市静安区中心医院肾内科,200040 [2]解放军第四五五医院肾内科

出　　处：《中国医师进修杂志》2007年第12期9-11,14,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨不同透析器、不同透析模式对维持性血液透析患者血浆总同型半胱氨酸（tHcy）浓度的影响。方法选择门诊维持性血液透析患者60例，随机分成四组，每组15例，分别使用三醋酸纤维膜透析器（S130组）、低通量聚砜膜透析器（F6组）和高通量聚砜膜透析器（F60组）进行血液透析以及使用高通量聚砜膜透析器进行血液透析滤过（HDF组），为期2个月。结果（1）四组患者单次透析治疗对血浆tHcy、SCr、BUN的清除作用差异无统计学意义（P〉0．05）。但对β2-MG的清除，高通量透析器（F60组和HDF组）明显高于低通量透析器（S130组和F6组），HDF组明显高于F60组，P〈0．05。（2）经过2个月的治疗，各组患者试验前后SCr和BUN血浆浓度无明显变化，P〉0．05；血浆tHcy、β2-MG浓度除了HDF组有明显下降（P〈0．05）外，其他三组无明显变化，P〉0．05。结论常规血液透析无论使用低通量透析器还是高通量透析器对血浆tHcy的清除作用相似，高通量聚矾膜透析器进行血液透析滤过对血浆tHcy的长期清除作用优于常规血液透析。Objective To investigate the effect of different dialysers or different dialysis＇patterns on the plasma total homocystine （tHcy） in patients with maintenance hemodialysis （MHD）. Methods Sixty outpatients with MHD were randomly divided into four groups, 15 patients each group. The patients were dialyzed with triacetate membrane （S 130 group）, low flux polysulfone membrane （F6 group）and high flux polysulfone membrane （F60 group） or hemodiafihrated with polysulfone membrane （HDF group） for two months, respectively. Results There were no significant differences among the four groups with respect to the removal of plasma tHcy, SCr, BUN during a single dialysis session,P 〉 0.05, but the clearance of β2-MG in high flux dialyser （F60 group and HDF group） was better than that in low flux dialyser （S130 group and F6 group）,best in HDF group,P〈 0.05. There were no changes of SCr and BUN among the four groups after two months,P 〉 0.05. No significant changes except for the reduction in HDF group （P 〈 0.05） in plasma tHcy levels were observed among the other three groups after two months of dialysis. Conclusion The homocystine reduction ratio is not different between low flux dialyser and high flux dialyser during single dialysis session, but HDF can significantly lower tHcy in two months in MHD patients.

关 键 词：血液透析 血液透析滤过 透析器 同型半胱氨酸 

分 类 号：R692[医药卫生—泌尿科学] R45[医药卫生—外科学]