应用聚甲基丙烯酸甲酯膜进行透析治疗尿毒症患者瘙痒的临床疗效分析  

Polymethylmethacrylate dialysis membranesplay in uraemic itching

作　　者：龙春姣[1] 李远明[1] 申永超[1] 伍锟[1] 

机构地区：[1]中南大学湘雅三医院肾内科,湖南长沙410003

出　　处：《中国现代医学杂志》2009年第17期2677-2679,共3页China Journal of Modern Medicine

摘　　要：目的探讨应用聚甲基丙烯酸甲酯膜进行血透对尿毒症患者瘙痒的影响。方法随机选取40例平时予普通透析膜进行血透的存在慢性瘙痒的尿毒症患者。瘙痒的强度和持续时间评价通过病人本身在每个观察点使用视觉模拟评分(VAS)评估。40例患者随机分为两组,A组(18例)采用原透析膜进行透析,B组(22例),采用聚甲基丙烯酸甲酯膜进行透析,经过评估后两组患者均按计划进行血透,并于透析3个月后,抽血检查血红蛋白,红细胞压积、肾功能、甲状旁腺素(PTH)、β2-微球蛋白和C-反应蛋白(CRP)的水平,以及患者一般情况的记录。结果A组自我视觉模拟评分(VAS)瘙痒强度分数3个月后无明显变化。B组患者瘙痒症状改善明显,自我视觉模拟评分(VAS)瘙痒强度分数3个月后下降了51%,两组比较差异有显著性(P<0.05)。两组患者更换治疗前后血压和肾功能、CRP水平无明显变化,但B组β2-微球蛋白水平显著降低。结论应用聚甲基丙烯酸甲酯膜透析器进行血透可改善尿毒症透析患者的瘙痒问题。[ Objective ] To explore the effects of Polymethylmethacrylate-based dialysis membranes （PMMA） in haemodialysis （HD） patients who suffered from chronic itching. [Methods] Our study enrolled fourty patients who suffered from chronic itching. The strength and duration of itching was evaluated at each study time-point using a visual analogue scale （VAS）. All patients were randomly divided into group A and group B. The dialysis membrane for group A was the baseline synthetic membranes, The dialysis membrane for group B was PMMA. After a baseline evaluation, haematocrit, total protein, albumin, urea, ereatinine, phosphate, intact parathyroid hormone （i-PTH）, serum bile acid, β2-microglobulin, C-reactive protein （CRP） levels were measuered and general complaints were recorded after 3 months. [Results] VAS scores decreased 51% after 3 months in group B and was not changed in Group A. There were no statistically significant differences in the pre-dialysis blood chemistry values and CRP level, but β2-microglobulin levels significantly decreased in group B. [ Conclusion ] These findings support the hypothesis that a PMMA dialyser may improve uraemic itching in ESRD patients.

关 键 词：血液透析 聚甲基丙烯酸甲酯膜 尿毒症瘙痒 

分 类 号：R692.5[医药卫生—泌尿科学]