不同血液净化方式对维持性血液透析患者非对称性二甲基精氨酸的影响  

Effect of different blood purification methods on the clearance of asymmetric dimethylarginine in the blood of maintenance hemodialysis patients

作　　者：苗小梅 马文录[1] 赵臣[1] 阮超 陶丹 李冰 夏芳芳 Miao Xiaomei;Ma Wenlu;Zhao Chen;Ruan Chao;Tao Dan;Li Bing;Xia Fangfang(Department of Nephrology,Baotou Guoyao Beifang Hospital,Baotou 014030,China)

机构地区：[1]内蒙古包头市国药北方医院肾内科,包头014030

出　　处：《国际移植与血液净化杂志》2024年第3期4-6,共3页International Journal of Transplantation and Hemopurification

摘　　要：目的探讨不同血液净化方式对血液透析患者体内非对称性二甲基精氨酸(asymmetric dimethylarginine,ADMA)浓度的影响。方法随机选取国药北方医院透析中心维持性血液透析3个月以上的患者90例,按照不同的血液净化方式分为血液透析组(hemodialysis,HD)30例,血液透析滤过组(hemodiafiltration,HDF)30例,血液灌流组(hemoperfusion,HP)30例,治疗时间3个月。收集治疗前后患者的血浆标本,检测ADMA浓度,监测患者血压、心率,超声检测颈部血管内膜厚度,计算动脉粥样硬化指数及斑块数量等相关数值,对比治疗前后各组指标。结果治疗前,三组患者的体重、收缩压、舒张压、心率、ADMA、动脉粥样硬化指数、血管内膜厚度及斑块数量比较,差异无统计学意义(P>0.05)。治疗3个月后,三组患者收缩压、舒张压、心率、ADMA、动脉粥样硬化指数、内膜厚度及斑块数量,与同组治疗前比较均有统计学差异(P<0.05),其中HP组和HDF组患者的收缩压及舒张压较HD组更低(P<0.05)。治疗后三组心率比较,差异无统计学意义(P>0.05)。治疗后HP组和HDF组的ADMA含量,动脉粥样硬化指数、内膜厚度及斑块数量等各项指标与HD组患者对比,差异具有统计学意义(P<0.05)。HP组和HDF组之间的收缩压、舒张压、心率、ADMA含量、动脉粥样硬化指数、内膜厚度及斑块数量比较差异无统计学意义(P>0.05)。结论三种血液净化治疗方式均可不同程度降低血液透析患者血浆ADMA的含量,且可改善患者血压及动脉硬化指标。ObjectiveTo investigate the effect of different blood purification methods on the concentration of asymmetric dimethylarginine(ADMA)in dialysis patients.MethodsA total of 90 patients with maintenance hemodialysis for more than 3 months in the dialysis center of Baotou Guoyao Beifang Hospital were randomly selected and divided into hemodialysis(HD)group(30 cases),hemodiafiltration(HDF)(30 cases),and hemoperfusion(HP)group(30 cases)according to different blood purification methods.The duration of treatment is three months.Plasma samples were collected from patients before and after treatment,the concentration of ADMA was detected,the blood pressure and heart rate of patients were monitored,the thickness of the cervical vascular intima was detected by ultrasound,the atherosclerosis index and the number of plaques and other related values were calculated,and the indexes of each group before and after treatment were compared.ResultsBefore the treatment,there were no significant differences in body weight,systolic blood pressure,diastolic blood pressure,heart rate,ADMA,atherosclerosis index,vascular intima thickness and plaque number among the three groups(P>0.05).After 3 months of treatment,there were statistically significant differences in systolic blood pressure,diastolic blood pressure,heart rate,ADMA,atherosclerosis index,intimal thickness and number of plaques in the three groups(P<0.05).The systolic blood pressure and diastolic blood pressure of the HP group and HDF group were lower than those of the HD group(P<0.05),and there was no significant difference in heart rate between the three groups after treatment(P>0.05).After treatment,there were significant differences in ADMA content,atherosclerosis index,intimal thickness and plaque number in the HP group and HDF group when compared with those in the HD group(P<0.05).There were no significant differences in systolic blood pressure,diastolic blood pressure,heart rate,ADMA content,atherosclerosis index,intimal thickness and plaque number between the HP group and

关 键 词：血液透析 动脉粥样硬化 非对称性二甲基精氨酸 

分 类 号：R692.5[医药卫生—泌尿科学]