不同血液净化方式对继发性甲状旁腺功能亢进患者的影响  

The effect of different blood purification methods on patients with secondary hyperparathyroidism

作　　者：王杰[1] 张有才[1] 郭仲琴[1] 慕晓霞[1] 王百聆[1] 王品[1] 陈琳[1] 

机构地区：[1]焦作市人民医院肾内科,河南焦作454002

出　　处：《河南医学研究》2015年第6期29-31,共3页Henan Medical Research

摘　　要：目的比较两种常见的血液净化方式对维持性血液透析(maintenance hemodialysis,MHD)患者甲状旁腺激素(i PTH)、钙、磷水平的影响。方法将40例维持性血液透析患者随机分为两组:血液透析滤过组(HDF),血液透析滤过+血液灌流组(HDF+HP),每组20例。HDF组进行常规透析(2次/周,4 h/次)和血液滤过(1次/周,4 h/次)治疗;HDF+HP组进行常规血液透析(2次/周,4 h/次)和血液滤过+灌流(1次/周,4 h/次)治疗,3个月后比较2种血液净化治疗对血清磷离子、钙离子和i PTH的清除率。结果两组患者治疗后血甲状旁腺激素水平及血磷水平较治疗前下降,血钙水平较治疗前上升,而HDF+HP组较HDF组血甲状旁腺素水平下降明显,差异均具有统计学意义(P<0.05);治疗后两组血磷及血钙水平比较,差异无统计学意义(P>0.05)。结论在透析滤过的基础上联合血液灌流能更好地清除i PTH,故对治疗透析患者甲状旁腺功能亢进起到一定作用。Objective To compare the effects of different flood purification methods on parathyroid hormone,phosphorus and calcium in maintenance hemodialysis（ MHD）patients with secondary hyperparathyroidism. Methods Forty patients were ran-domly divided into two groups：hemodiafiltralysis group（ HDF group）and hemodiafiltralysis plus hemoperfusion group（ HDF＋HP）,20 patients in each group. The HDF group received conventional hemodialysis（2 times per week and 4 hours each session） and hemodiafiltralysis（1 time per week and 4 hours each session）. The HDF＋HP group received conventional hemodialysis（2 times per week and 4 hours each session）and hemodiafiltralysis plus hemoperfusion（1 time per week and 4 hours each session）. The levels of serum phosphorus,calcium and serum iPTH were observed before and after treatment. Results After treatment, the levels of serum iPTH and phosphorus in both HDF group and HDF＋HP group were decreased significantly,calcium were in-creased. Compared with the HDF group,the level of iPTH in the HDF＋HP group were decreased significantly（P﹤0. 05）. The change of phosphorus and calcium in both HDF group and HDF＋HP group were unsignificant（P﹥0. 05）. Conclusion The treatment of hemodiafiltralysis plus hemoperfusion could effectively clear iPTH in maintenance hemodialysis patients with seconda-ry hyperparathyroidism.

关 键 词：血液灌流 血液透析滤过 甲状旁腺激素 血磷 血钙 

分 类 号：R459.5[医药卫生—治疗学]