不同血液净化方式对尿毒症皮肤瘙痒的疗效观察  

Influence of various blood purification methods on skin itching in patients subject to maintenance hemodialysis

作　　者：王济东[1] 李春庆 陈英兰 宋丹[1] 闫丰[1] 

机构地区：[1]南京医科大学附属无锡市第二人民医院肾内科,214002 [2]无锡市中西医结合医院肾内科

出　　处：《临床肾脏病杂志》2012年第2期67-69,共3页Journal Of Clinical Nephrology

摘　　要：目的探讨不同血液净化方式对尿毒症皮肤瘙痒的治疗效果。方法选择70例尿毒症规律性血液透析伴皮肤瘙痒患者，分为血液灌流串联血液透析（HP／HD组）、血液透析滤过（HDF组）、高通量透析（HFD组）、普通血液透析（HD组）进行治疗。观察皮肤瘙痒等临床症状缓解情况及血清甲状旁腺素等指标变化。结果HP／HD组、HDF组、HFD组治疗前后，血清PTH水平下降，皮肤瘙痒明显缓解；与HD组比较差异有统计学意义（P〈0．01或P〈0．05）。结论血液灌流串联血液透析和血液透析滤过、高通量透析较普通血液透析能更有效的清除PTH，可有效缓解皮肤瘙痒等症状。Objective To explore the influence of various blood purification methods on skin itching in patients subject to maintenance hemodialysis. Methods Seventy patients subject to maintenance hemodialysis （MHD） for more than 6 months were randomly divided into HD group （n = 15）, HFD group （n = 15）, HDF group （n = 20） and HD plus HP group （n = 20）. Skin itching remission in patients was observed per day. Blood biochemical parameters and serum parathyroid hormone （PTH） were measured in patients before and after the first dialysis session, and after the treatment for both 2 weeks and 4 weeks. Results Compared with regular HD group, there were statistically significant differences in eliminating serum PTH in HD plus HP （P〈0. 01 ）, HDF （P〈0. 05） and HFD （P〈 0. （15） group, with remission rate of skin itching respectively 86% （17/20）, 75% （15/20）, 73.33% （11/15）. Conclusions Serum PTH and skin itching in MHD patients can be effectively eliminated by HDF, HD＋ HP, or HFD, but not by regular hemodialysis.

关 键 词：尿毒症 瘙痒症 血液透析滤过 

分 类 号：R587.2[医药卫生—内分泌]