血液透析联合血液灌流治疗对维持性血液透析患者的影响  

Influence of hemodialysis in combination with hemoperfusion on patients with maintenance hemodialysis

作　　者：张颖娟[1] 薛琳[1] 张家菊[1] 罗建琼 文鸿[1] 王萍[1] 

机构地区：[1]攀枝花市中心医院肾内科,四川攀枝花617067

出　　处：《四川医学》2012年第12期2112-2114,共3页Sichuan Medical Journal

摘　　要：目的探讨血液透析联合血液灌流治疗能否提高维持性血透患者中大分子毒素的清除,以及对患者贫血、血压、皮肤瘙痒的影响。方法采用前瞻性、自身前后对照研究,选取56名维持性血透患者,先予血液透析(HD组)治疗观察3个月,每周行HD3次;然后改为血液透析+血液灌流(HD+HP组)治疗3个月,每周2次HD及1次HD+HP。观察患者血压、皮肤瘙痒情况,同时检测血全段甲状旁腺激素(iPTH)、β2-微球蛋白(β2-MG)、C反应蛋白(CRP)、胱抑素C(CysC)、清蛋白(ALB)、血红蛋白(HGB)。结果治疗3个月后,与HD组比较,HD+HP组血压控制达标者较多(P<0.05),皮肤瘙痒改善率较高(P<0.01),血iPTH、β2-MG、CRP、CysC均明显降低(P<0.01),HGB明显升高(P<0.05)。两组患者在治疗过程中均无不良反应发生。结论 HD联合HP治疗与单独HD相比,更能有效清除大中分子尿毒症毒素,改善患者生活质量。Objective To investigate whether hemedialysis in combination with hemoperfusion improve the clearance rate of middle-and large-molecule uremic toxins so as to have effect on anemia, blood pressure（BP） and itchy skin in patients with ma- intenance hemodialysis. Methods A prospective, self control study was carried out. Fifty six patients were selected to receive he- modialysis three times a week （ HD group） for 3 months and then hemodialysis twice a week plus hemodialysis in combination with hemoperfusion once a week （ HD ＋ HP group） for the next 3 months. Blood pressure and＇the severity of itchy skin were recorded. Hemoglobin, albumin, iPTH, I82-MG, CRP, CysC in blood were detected. Results At the end of the 3-months observation, more patients in HD ＋ HP group got well-controlled BP（ P 〈 0. 05 ）and improved itchy skin（ P 〈0. 01 ） than HD group. Compared to HD group, the level of.iPTH, 132-MG, CRP and CysC in blood were significantly lower（ P 〈 0. 01 ） and hemoglobin higher（ P 〈 0. 05 ） in HD ＋ HP group. There was no adverse effect occurred during treatment in both groups. Conclusion Hemodialysis in combination with hemoperfusion is superior to hemedialysis alone in eliminating middle- and large-molecules uremic toxins and improving the quality of life in patients with maintenance hemodialysis.

关 键 词：血液透析 血液灌流 中大分子毒素 

分 类 号：R459.5[医药卫生—治疗学]