三种不同血液净化方式对尿毒症患者血清中β2-MG钙磷浓度及甲状旁腺激素水平的影响  

Effects of Three Different Blood Purification Methods on Serum β2-MG Calcium and Phosphorus Concentrations and Parathyroid Hormone Levels in Patients with Uremia

作　　者：王宇静[1] WANG Yujing(Haikou Hospital Affiliated to Xiangya Medical College,Central South University, Hainan Haikou 570208, China)

机构地区：[1]中南大学湘雅医学院附属海口医院

出　　处：《河北医学》2019年第8期1295-1299,共5页Hebei Medicine

基　　金：海南自然科学基金面上项目,(编号:817384)

摘　　要：目的:分析三种不同血液净化方式对尿毒症患者血清中β2微球蛋白(β2-MG)、钙磷浓度及甲状旁腺激素(PTH)水平的影响.方法:选取2015年5月至2018年5月我院收治的尿毒症患者100例为研究对象,随机分为HFHD组(行高通量血液透析治疗,n=34)、HDF组(进行血液透析滤过治疗,n=32)、HD+HP组(接受血液透析串联血液灌流治疗,n=34),均治疗3个月,比较三组治疗总有效率、治疗前后血肌酐(Scr)、尿素氮(BUN)、KT/V值及血清β2-MG、血钙、血磷、钙磷乘积、PTH水平.结果:HFHD组、HD+HP组治疗总有效率分别为91.18%、94.12%,均明显高于HDF组的68.75%(P<0.05);治疗后三组BUN、Scr均下降,但三组间BUN、Scr、KT/V值比较差异无统计学意义(P>0.05);治疗后HFHD组、HD+HP组血清β2-MG、血磷、钙磷乘积、PTH水平明显低于HDF组,HFHD组、HD+HP组上述指标比较差异也有统计学意义(P<0.05).结论:三种血液净化方式均可较好治疗尿毒症,其中HFHD或HD+HP治疗效果及对血清β2-MG、血磷、钙磷乘积、PTH的改善效果优于HDF,尤以HD+HP作用最明显.Objective: To analyze the effects of three different blood purification methods on serum β2 microglobulin (β2-MG), calcium and phosphorus concentrations and parathyroid hormone (PTH) levels in patients with uremia. Methods: A total of 100 patients with uremia who were admitted to the hospital during the period from May 2015 to May 2018 were selected as subjects. They were randomly divided into HFHD group (treated with high-flux hemodialysis, n=34), HDF group (treated with hemodiafiltration, n=32) and HD+HP group (treated with hemodialysis and hemoperfusion, n=34). All groups were given 3 months of treatment. The total treatment response rate, serum creatinine (Scr), blood urea nitrogen (BUN), KT / V value, serum β2-MG, blood calcium, serum phosphorus, calcium-phosphorus product and PTH levels before and after treatment were compared among the three groups. Results: The total treatment response rate of HFHD group (91.18%)or HD+HP group (94.12%) were significantly higher than that of HDF group (68.75%)(P<0.05). The BUN and Scr in all groups were after treatment, but there was no significant difference in BUN, Scr or KT/V value among the three groups (P>0.05). Theserum β2-MG, serum phosphorus, calcium-phosphorus product and PTH levels in HFHD group and HD+HP group were significantly lower than those in HDF group, with statistically significant differences between HFHD group and HD+HP group (P<0.05). Conclusion: All of the three blood purification methods can well treat uremia. The therapeutic effects and the improvement of serum β2-MG, blood phosphorus, calcium-phosphorus product and PTH by HFHD or HD+HP are better than HDF, especially HD+HP.

关 键 词：血液净化 尿毒症 Β2-MG 钙 磷 甲状旁腺激素 

分 类 号：R692.5[医药卫生—泌尿科学]