联机血液透析滤过和高通量透析对尿毒症患者中大分子物质的清除效果  

Comparison between on-line hemodiafiltration and high-flux hemodialysis for middle-molecule solues removal

作　　者：蔡晓萍[1] 刘斌[1] 华佳[1] 张志坚[1] 张秋华[1] 张悦[1] 周薇[1] 孙铸兴[1] 

机构地区：[1]南京医科大学附属医院无锡市人民医院肾内科,江苏无锡214023

出　　处：《实用临床医药杂志》2014年第19期182-184,共3页Journal of Clinical Medicine in Practice

摘　　要：目的分析比较联机血液透析滤过(OL-HDF)和高通量透析(HFHD)清除尿毒症患者中大分子量毒素的效果。方法选取160例本院血液净化中心稳定的长期维持性血液透析(MHD)患者进入本研究,随机分为A组80例行后稀释法OL-HDF,B组80例行HFHD治疗,分别于单次OL-HDF、HFHD治疗前、治疗结束时取血检测患者血β2-微球蛋白(β2-MG)、血全段甲状旁腺激素(iPTH)、血清尿素氮(BUN)、血清肌酐(Cr)、血浆白蛋白(ALB)水平。结果比较治疗前后2组患者血β2-MG、血iPTH、BUN、Cr值,差异有统计学差异(P<0.01);组间治疗前比较差异无统计学意义(P>0.05),而治疗后A组(OL-HDF)血β2-MG、iPTH值的下降更明显,P<0.05。结论 2种方法均可有效清除血β2-MG、血iPTH,但OLHDF比HFHD能清除更多的血β2-MG、血iPTH,OL-HDF对中大分子毒素的清除更有效。Objective Middle-molecule solues could be removed by on-line hemodiafiltration（OL-HDF）and high-flux dialysis（HFHD）.In this study,two blood purification methods of middle-molecule solues were compared in end-stage renal disease patients.Methods We investigated 160 maintenance hemodialysis（MHD）patients,and evenly divided into two groups.Group A was treated with postdilution OL-HDF,while Group B was treated with HFHD.The values of bloodβ2-microglobulin（β2-MG）,blood intact parathyroid hormone（iPTH）,serum urea nitrogen（BUN）,serum creatinine（Cr）,plasma albumin（ALB）were measured before and after single OL-HDF or HDHF.Results There were no significant differences between two groups before treatment（P〉0.05）.The levels ofβ2-MG,iPTH,BUN and Cr significantly changed（P〈0.01）,especially BUN and iPTH in Group A（P〈0.05）.Conclusion Two blood purification methods can effectively removeβ2-MG,iPTH,especially OL-HDF.Compared with HDHF,OL-HDF is more effective for middle-molecule solues removal.

关 键 词：联机血液透析滤过 高通量血液透析 血Β2-微球蛋白 甲状旁腺激素 

分 类 号：R692[医药卫生—泌尿科学]