高通量透析对V期糖尿病肾病患者血清甲状旁腺激素、β2-微球蛋白和晚期糖基化终末产物的影响  

The effect of high flux hemodialysis on parathyroid hormone,β2- microglobin and advanced glycation end products in patients with stage V diabetic nephropathy

作　　者：张国欣[1] 谷建斌[2] 刘娜[1] 薛兰芬[1] 聂丽敏 

机构地区：[1]河北省石家庄市第一医院肾内科,河北石家庄050011 [2]河北省石家庄市第一医院外科,河北石家庄050011

出　　处：《临床和实验医学杂志》2015年第21期1793-1796,共4页Journal of Clinical and Experimental Medicine

基　　金：石家庄市科技局项目(课题编号:081461603;课题名称:糖尿病肾病患者血清糖基化终末产物水平影响因素的分析研究)

摘　　要：目的研究高通量透析对V期糖尿病肾病(DN)患者血清甲状旁腺激素(PTH)、β2-微球蛋白(β2-MG)和晚期糖基化终末产物(AGEs)的影响。方法选取2010年1月至2012年3月收治的39例DN患者作为研究对象,随机分成两组:其中HD组19例患者接受血液透析,HFHD组10例患者接受高通量血液透析;选取同期体检健康者20例作为对照组。比较各组不同时间(透析治疗前、透析1个月、2个月、3个月、1年、2年和3年后)的血清PTH、β2-MG和AGEs水平。结果与对照组相比,DN患者不同时间PTH、β2-微球蛋白和AGEs水平均明显升高(P<0.05)。两组DN患者透析前、透析1个月和2个月的PTH和AGEs水平无统计学差异(P>0.05),透析3个月、1年、2年和3年,HFHD组的PTH和AGEs均明显低于HD组,差异具有统计学意义(P<0.05)。HFHD组透析后不同时间的β2-MG水平均明显低于HD组,差异具有统计学差异(P<0.05)。结论 HFHD可以有效清除V期DN患者血清中的PTH、β2-MG和AGEs,其效果优于常规HD。Objective To study the effect of high flux hemodialysis on parathyroid hormone（PTH）,β2 - microglobin（β2 - MG）and advanced glycation end products（AGEs）in patients with stage V diabetic nephropathy（DN）. Methods From January 2010 to March 2012,39 patients with DN were chosen as study objects,all patients were divided into 2 groups randomly：19 patients in hemodialysis（HD）group and 20 patients in high flux hemodialysis（HFHD）group. At the same time,20 healthy people were chosen as control group. The levels of PTH,β2 -MG and AGEs of three groups at different time（before treatment,1 month,2 months,3 months,1 year,2 years and 3 years after treatment）were compared. Results Compared with control group,the levels of PTH,β2 - microglobin and AGEs increased significantly in patients with DN（ P﹤ 0. 05）. Before treatment,1 month,2 months after treatment,the levels of PTH and AGEs had no statistical difference between HD group and HFHD group（ P ﹥ 0. 05）. 3 months,1 year,2 years and 3 years after treatment,the levels of PTH and AGEs in HFHD group were lower than those in HD group,the differences had statistical significance（ P ﹤ 0. 05）. After treatment,the level of β2 - MG in HFHD group was lower than that in HD group,the difference had statistical significance（ P ﹤ 0. 05）. Conclusion The high flux hemodialysis can clear PTH,β2 - MG and AGEs in patients with DN,and its efficacy is better than conventional hemodialysis.

关 键 词：糖尿病肾病 高通量透析 甲状旁腺激素 β2 - 微球蛋白 晚期糖基化终末产物 

分 类 号：R587.2[医药卫生—内分泌] R692.5[医药卫生—内科学]