摘要
目的:探讨高通量血透(HFD)的安全性及临床应用价值。方法:选取在本院血液净化中心长期维持性血透且病情稳定、透析病程在半年以上的患者15例。测定普通血透(CHD)前后的血尿素氮(BUN)、肌酐(Scr)、血脂、β2-微球蛋白(β2-MG)、氨基酸谱等,然后将患者改行高通量血透,持续进行3个月,再测定HFD前后的上述相同指标。另外测定15例年龄、性别相匹配的健康体检者的血清氨基酸谱作为对照。结果:①CHD和HFD对BUN、Scr的清除差异无显著性。②HFD3个月后,透前血胆固醇无显著性改变,但血甘油三酯有明显下降([1.53±1.11)vs(2.02±1.41)mmol/L,P=0.035)]。③单次HFD使血β2-MG明显下降([13.44±0.78)vs(10.40±1.26)mg/dl,P=0.000],CHD不能使血β2-MG下降,反而升高([13.45±0.50)vs(13.70±0.53)mg/dl,P=0.09]。但连续HFD3月后,透前血β2-MG并无显著下降[(13.44±0.78)vs(13.45±0.50)mg/dl,P=0.947]。④单次CHD和HFD对血清总氨基酸浓度无显著影响。高通量血透前患者血清总氨基酸浓度低于健康对照([765.01±304.97)vs(1182.50±295.48)μmol/L,P=0.002];高通量血透3月后,血清总氨基酸水平明显升高,与健康对照相比差异无显著性[(1599.41±1131.79)vs(1182.50±295.48)μmol/L,P=0.087]。结论:HFD有利于降低血透患者的甘油三酯,对血清β2-MG的清除更明显,单次HFD对血清总氨基酸浓度无显著影响。连续HFD可改善血透患者血清氨基酸谱,可能与胃纳改善,营养物质摄入增加有关。短期观察发现HFD安全有效,比CHD有一定优势。
Objective：To investigate the safety and clinical value of high-flux hemodialysis（HFD）. Methods： Fifteen chronic uremic patients who were undergone maintenance hemodialysis were enrolled in this study. They were all in stable state of disease and have dialysis courses more than half a year. The blood urea nitrogen（BUN）, serum creatinine（Scr）, cholesterol,triglyceride, β2-MG and amino acids were measured before and after common hemodialysis （CHD）. Then the patients were switched to high-flux hemodialysis（HFD） and continued for 3 months. The same indexes were measured before and after HFD. The serum amino acids of 15 sex and age matched healthy were measured as control. Results： （1）There were no difference of the clearance of BUN and Scr between CHD and HFD. （2）After 3 months of HFD, the blood cholesterol level before dialysis showed no significant changes, but blood triglyceride was significantly decreased [（1.53 ± 1.11） vs （2.02±1.41） mmol/L, P=0.035]. （3）There was a significant lowering of serum β2-MG level after HFD （one time） [（13.44±0.78） vs （10.40±1.26） mg/dl, P=0.000], but after 3 months of HFD, the serum β2-MG level before dialysis showed no significant lowering[（13.44±0.78） vs （13.45±0.50） mg/dl,P=0.947]. CHD could not clear away β2-MG, one time CHD caused a slight increasing of blood β2-MG level[（13.45±0.50） vs （13.70 ± 0.53） mg/dl,P=0.09]. （4）Both one time CHD and HFD had no significant influence on serum amino acids concentrations. Before HFD, the patients＇ serum total amino acids（TAA） were significantly lower than that of normal control[（765.01 ± 304.97） vs （1182.50±295.48） μmol/L, P=0.002]. After 3 months of HFD,the patients＇ serum TAA levels were increased significantly and showed no significant difference compared with the healthy control[（1599.41 ± 1131.79） vs （1182.50±295.48） μmol/L, P=0.087]. Conclusion： HFD is helpful in decreasing serum triglyceride level and has better effects for elimination of serum β2-MG. There is no significant change of serum TAA in one time HFD, but continued HFD can improve the patients amino acids profile and this is probably due to increased intake of nutrients. HFD is safe and effective, and it is better than CHD in certain aspects.
出处
《温州医学院学报》
CAS
2007年第3期267-270,共4页
Journal of Wenzhou Medical College
