间断血液透析滤过治疗对改善透析相关性肌痉挛的疗效观察  

作　　者：刘滇军[1] 刘辉辉[1] 沈建明[1] 田少江[1] 王黎萍[1] 李骏峰[1] 

机构地区：[1]湖北医药学院附属人民医院肾内科,442000

出　　处：《浙江临床医学》2014年第4期533-535,共3页Zhejiang Clinical Medical Journal

摘　　要：目的观察血液透析联合间断血液透析滤过治疗对改善透析相关性肌痉挛的疗效和探讨可能机制。方法32例血液透析中频发肌痉挛患者随机均分为血液透析治疗（A组）和血液透析治疗联合间断血液透析滤过治疗（B组）两组，于3个月的治疗期内记录其透析相关性肌痉挛的发作次数，并在治疗开始前及治疗的第3个月于透析间期检测肱动脉内皮依赖性血管舒张功能（endothelium dependent dilation，EDD）、血浆血管性假性血友病因子（vWF）；另随机选择15例健康志愿者作为正常对照组（C组），检测EDD、vWF。结果在治疗期内，A组患者透析相关性肌痉挛发作次数变化不明显，B组显著减少（P〈O．01）。治疗前两组患者的EDD、vWF水平差异无统计学意义，而与正常对照相比较EDD均明显下降、vWF明显升高（P〈O．01）；治疗后A组EDD水平显著低于B组、vWF水平则明显高于B组，差异均有统计学意义（P〈O．01）。结论血液透析联合间断血液透析滤过治疗可有效改善患者的透析相关性肌痉挛，其机制可能与患者的内皮功能得到改善有关。Objective To discuss the effect and possible mechanism of hemodialysis intermittently combined with hemodiafiltration in patients with frequent hemodialysis-related muscle cramps. Methods Thirty-two patients with frequent hemodialysis-related muscle cramps were randomly divided into group A （ hemodialysis group, n=16 ） and group B （ hemodialysis intermittently combined with hemodiafiltration group, n=16 ） . The episodes of hemodialysis-related muscle cramps were recorded over a 3-month period. Endothelium dependent dilations （ EDD ） were measured in the brachial artery and plasma levels of vWF were measured at a mid-interdialysis day before the period and in third month of the period. 15 healthy volunteers were randomly chose to measure EDD, vWF as C group （ normal control group ） . Results In the treatment period, the incidence of hemodialysis-related cramps didn＇t reduce remarkably in group A （ P〉0.05 ） , but reduced remarkably in group B, and after the treatment period, the incidence of hemodialysis-related cramps in group A was significantly higher than in group B （ P〈0.0l ） . Before the period, there was no significant difference in EDD and plasma vWF between two group （ P〉0.05 ） .After the period, EDD was lower significantly in group A comparing with that in group B. While, plasma vWF was significantly higher in group A than in group B （ 19〈0.01 ） . Conclusion Hemodialysis intermittently combined with hemodiafiltration can effectly improve frequent hemodialysis-related muscle cramps in such patients, improving endothelial function maybe is the possible mechanism.

关 键 词：血液透析 血液透析滤过 肌痉挛 

分 类 号：R459.5[医药卫生—治疗学]