高通量透析对血透患者中分子毒素及左心室结构的影响  

Effect of High Flux Hemodialysis on Middle Molecular Weight Toxins and Left Ventricular Structure

作　　者：於建根[1] 张小云[1] 杨爱华[1] 

机构地区：[1]杭州市萧山第一人民医院,浙江杭州311200

出　　处：《中国医学创新》2016年第8期53-56,共4页Medical Innovation of China

基　　金：杭州市科技局课题(124772)

摘　　要：目的:探讨高通量透析对血液透析患者中分子毒素及左心室结构的影响。方法:选取本院尿毒症维持性血液透析(MHD)患者40例,随机分为高通量透析(HFD)组和常规通量透析(CHD)组,每组各20例,检查患者的血红蛋白(HGB)、血肌酐(Cr)、尿素氮(BUN)、血清白蛋白(ALB)、血磷(P)、血钙(Ca)、β2-微球蛋白(β2-MG)、甲状旁腺激素(i PTH)、超敏C-反应蛋白(CRP)、甘油三酯(TG)、总胆固醇(CHOL)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)指标;心脏超声检测心脏左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左室射血分数(EF值)、左心室后壁厚度(LVPWT)、室间隔厚度(IVST)、左房内径(LAD),分别对比0、6、12个月以上指标的改善情况。结果:HFD组6、12个月血β2-MG、i PTH水平较0个月明显降低,比较差异有统计学意义(P<0.05),HFD组6、12个月血CRP、ALB较0个月有所好转,比较差异有统计学意义(P<0.05),而CHD组各个指标6、12个月与0个月比较差异无统计学意义(P>0.05);HFD组6、12个月心超指标LVESD、LVEDD、EF值、IVST、LVPWT较0个月有所改善,比较差异均有统计学意义(P<0.05),而CHD组心超各个指标6、12个月较0个月均无统计学差异(P>0.05)。结论:HFD较CHD组能更有效地降低MHD患者中分子毒素水平,并且能更有效改善MHD患者的左室结构和功能。Objective： To investigate the effect of high flux hemodiafihration （ HFD ） on middle molecular weight toxins and left ventricular structure of maintenance hemodialysis patients of uremia.Method： 40 MHD patients were randomly divided into the HFD group and the CHD （ conventional hemodialysis ） group, 20 cases in each group.the blood samples of HGB, Cr, BUN, ALB, P, Ca, 13 2-MG, iPTH, CRP, TG, CHOL, HDL, LDL, the left ventricular structure and function parameters （ LVESD, LVEDD, EF, LVPWT, LVST and LAD ） by echocardiogram at 0, 6, 12 months were detected.Result： The level of serum 13 2-mieorglobulin, iPTH were significantly decreased after treatment for 6 months and 12 months in HFD group （ P〈0.05 ）, the level of CRP and ALB were significantly improved after treatment for 6 months and 12 monthsin HFD group （ P〈0.05 ） . All of the blood samples were not improved after treatment for 6 months and 12 months in CHD group （ P〉0.05 ）, the left ventricular structure and function parameters （ LVESD, LVEDD, EF, LVPWT, IVST ） were improved after treatment for 6 months and 12 months in HFD group （ P〈0.05 ）, but not improved in CHD group （ P〉0.05 ） . Conclusion： Comparing with CHD, HFD can significantly clear the middle molecular weight toxins of maintenance hemodialysis patients of uremia, and improve the left ventricular structure and function.

关 键 词：高通量透析 中分子毒素 左心室结构 

分 类 号：R692.5[医药卫生—泌尿科学]