Hemofiltration　or　hemodiafiltration　with　on-line　production　of　substitution　fluid: clinical　observation　of　safety　and　effectiveness  

作　　者：李学旺 李明喜 刘彤 李莉 段琳 李艳 杨桂琴 郭莉 

出　　处：《Chinese Medical Journal》1997年第7期24-29,共6页中华医学杂志（英文版）

摘　　要：Objective To observe the safety and cardiovascular stabi lity of on line hemofiltration (HF) or hemodialfiltration (HDF) and evaluate the clinical effectiveness of one HF or HDF session in addition to two hemodialysis (HD) sessions weekly. Methods Forty patients were randomly divided into four groups: group predilutional (PRD) HF (filtration rate: 259 333 ml/min),group predilutional HDF (filtration rate: 167 ml/min), group postdilutional (POD) HDF (filtration rate: 83 ml/min) and group bicarbonate HD. The reduction rate of parathyroid hormone (PTH), β 2 microglobulin (β 2MG), α 1 microglobulin (α 1MG) and KT/V in the initial treatment of every month was observed, and the incidence of hypotension and pyretic reaction during each treatment was evaluated. Results After 4 month observation, the KT/V for Group POD HDF is better than that for other three groups, and for Group PRD HDF is better than that for Group HF and HD. Serum level of PTH and β 2MG was not decreased after every treatment in Group HD, and so was serum level of α 1MG in all groups. Significant removal of PTH and β 2MG was observed in Group HF, PRD HDF and POD HDF. The monthly serum level of β 2MG and KT/V were stable in all groups, but the monthly serum level of PTH tended to be decreased in Group HF, PRD HDF and POD HDF. The incidence of pyretic reaction in HF or HDF was the same as in HD. Although the ultrafiltration volume was significantly higher during HF or PRD HDF than during HD, the incidence of hypotension in HF or PRD HDF was similar to that in HD. Conclusions On line HF or HDF proved to be a safe and reliable method. POD HDF mode seems to have the best KT/V, HF or PRD HDF offers a better choice for preventing intradia lytic hypotension. One HF or HDF session in addition to two HD sessions weekly is similarly effective to decrease the serum level of PTH and the proof of the clinical effectiveness of such a therapy awaits a long term observation.Objective To observe the safety and cardiovascular stabi lity of on line hemofiltration (HF) or hemodialfiltration (HDF) and evaluate the clinical effectiveness of one HF or HDF session in addition to two hemodialysis (HD) sessions weekly. Methods Forty patients were randomly divided into four groups: group predilutional (PRD) HF (filtration rate: 259 333 ml/min),group predilutional HDF (filtration rate: 167 ml/min), group postdilutional (POD) HDF (filtration rate: 83 ml/min) and group bicarbonate HD. The reduction rate of parathyroid hormone (PTH), β 2 microglobulin (β 2MG), α 1 microglobulin (α 1MG) and KT/V in the initial treatment of every month was observed, and the incidence of hypotension and pyretic reaction during each treatment was evaluated. Results After 4 month observation, the KT/V for Group POD HDF is better than that for other three groups, and for Group PRD HDF is better than that for Group HF and HD. Serum level of PTH and β 2MG was not decreased after every treatment in Group HD, and so was serum level of α 1MG in all groups. Significant removal of PTH and β 2MG was observed in Group HF, PRD HDF and POD HDF. The monthly serum level of β 2MG and KT/V were stable in all groups, but the monthly serum level of PTH tended to be decreased in Group HF, PRD HDF and POD HDF. The incidence of pyretic reaction in HF or HDF was the same as in HD. Although the ultrafiltration volume was significantly higher during HF or PRD HDF than during HD, the incidence of hypotension in HF or PRD HDF was similar to that in HD. Conclusions On line HF or HDF proved to be a safe and reliable method. POD HDF mode seems to have the best KT/V, HF or PRD HDF offers a better choice for preventing intradia lytic hypotension. One HF or HDF session in addition to two HD sessions weekly is similarly effective to decrease the serum level of PTH and the proof of the clinical effectiveness of such a therapy awaits a long term observation.

关 键 词：HEMODIAFILTRATION FLUID SUBSTITUTION SAFETY HEMOFILTRATION and 

分 类 号：R969[医药卫生—药理学]