高通量透析对患者白蛋白及甲状旁腺激素水平的影响  

Effects of high-flux dialysis on serum albumin and parathyroid hormone levels in hemodialysis patients

作　　者：任凯明[1] 郝峻烽[1] 邵兵[1] 张晓玲[1] 白久旭[1] 曹宁[1] 

机构地区：[1]沈阳军区总医院血液净化科,辽宁沈阳110016

出　　处：《临床军医杂志》2015年第9期951-954,959,共5页Clinical Journal of Medical Officers

摘　　要：目的探讨高通量透析对患者白蛋白及甲状旁腺激素水平的影响。方法采用回顾性病例对照设计,选取我院血液净化中心第二血液透析室维持性血液透析患者157例,按是否使用高通量透析器分为高通量组(69例)及低通量组(88例),比较两组间临床指标差异。结果两组比较发现,高通量组具有更高的白蛋白水平和肌酐水平,但尿素氮水平差异无统计学意义(P>0.05)。高通量组的患者β2微球蛋白水平更低,但两组间甲状旁腺激素、磷、钙、钙磷乘积、25羟维生素D3水平,差异均无统计学意义(P>0.05)。结论使用高通量透析者可较低通量透析者达到更高的白蛋白水平和更低的血清β2微球蛋白水平。高通量透析对控制维持性血液透析患者的甲状旁腺激素水平,并不比低通量透析,更有优势。Objective To explore the effect of high-flux dialysis on serum albumin and parathyroid hormone levels in hemodialysis pa-tients. Methods We retrospectively analyzed 157 patients on maintenance hemodialysis in our blood purification center,and all the patients were divided into high-flux and low-flux dialysis groups according to the type of dialysis membrane used in each group. Base-line demographic,clinical data and laboratory values were recorded and compared between the two groups. Serum samples were ob-tained pre-dialysis. Results Serum albumin and creatinine levels were significantly higher in patients of high-flux group,in whom ser-um β2-microglobulin was significantly lower. Levels of blood urea nitrogen,intact parathyroid hormone,serum phosphorus,calcium,cal-cium-phosphorus product and 25（OH）D3 levels were not significantly different between high and low-flux groups（P〉0. 05）. Conclu-sion High-flux dialyzer was more efficient in removal of β2-microglobulin and maintenance of serum albumin levels. There was no significant difference in serum intact parathyroid hormone levels between the high and the low-flux dialysis groups.

关 键 词：维持性血液透析 高通量透析 血清白蛋白水平 β2 微球蛋白 甲状旁腺激素 

分 类 号：R459.5[医药卫生—治疗学]