高通量血液透析对维持性血液透析患者血清叶酸、维生素B_(12)水平的影响  

Effects of high flux hemodialysis on serum folate and vitamin B12 in maintenance hemodialysis patients

作　　者：殷培[1] 李冀军[1] 宋岩[1] 赵长征[1] 龚红英[1] 王建红[1] 

机构地区：[1]中国人民解放军总医院第一附属医院肾内科,北京100048

出　　处：《中国血液净化》2011年第11期610-612,共3页Chinese Journal of Blood Purification

摘　　要：目的研究高通量血液透析治疗对维持性血液透析患者血清叶酸、维生素B12水平的影响。方法前瞻性、自身对照研究。30例常规低通量血液透析患者,转换为高通量透析(Fresenius FX60,超纯透析液)治疗6月。试验前(0月)采透析前,试验后3、6月分别采透析前、后血样测定血清叶酸、维生素B12的水平。结果转换为高通量血液透析与原低通量血液透析比较血清叶酸、维生素B12浓度没有变化。血清叶酸透析前水平从实验开始时0、3、6月分别为(5.16±0.87)ng/ml,(4.94±0.85)ng/ml与(4.75±0.77)ng/ml。虽然呈下降趋势,但组间比较没有统计学差异(t0/3=0.962,t0/6=1.826,t3/6=0.836,P>0.05)。血清叶酸水平透析前后无明显变化。血维生素B12透析前水平在试验前、后比较差异无统计学意义(t0/3=0.120,t0/6=0.337,t3/6=0.436P>0.05),分别为(419.13±136.83)pg/ml,(414.00±153.16)pg/ml与(432.83±139.12)pg/ml,透析前后血维生素B12水平没有变化。结论高通量血液透析治疗后未发现血清叶酸、维生素B12丢失增加。Objective This prospective and self-controlled study was designed to detect whether serum folate and vitamin B12 concentration improved in hemodialysis patients treated with high flux dialysis. Methods A total of 30 patients on maintenance low flux hemodialysis were included. After switching to high flux dialysis, dialysis prescription was unchanged except the change of dialyzer. Ultrapure dialysate was implied. Pre-dialysis blood samples were collected for measuring serum folate and vitamin B12. Post-dialysis blood samples were collected at 3 and 6 months after entering this study. Results Serum folate and vitamin B12 remained unchanged during the study process. Serum folate was 5.16±0.87ng/ml, 4.94±0.85ng/ml and 4.75±0.77ng/ml at 0, 3 and 6 months, respectively, of high flux dialysis. However, the declining trend of serum folate after high flux dialysis was statistically insignificant （P 〉0.05）. Serum vitamin B12 level was 419.13± 136.83 pg/ml, 414.00±153.16pg/ml and 432.83±139.12pg/m, at 0, 3 and 6 months, respectively, of high flux dialysis （P 〉0.05）. Therefore, serum folate and vitamin B12 levels were unchanged before and after the dialysis. Conclusions Our results show that shifting from low flux to high flux hemodialysis does not result in the decrease of serum folate and vitamin B12.

关 键 词：血液透析 高通量血液透析 叶酸 维生素B12 

分 类 号：R459.5[医药卫生—治疗学]