高通量血液透析可以有效地清除β_2微球蛋白和改善维持性血液透析患者的慢性炎症状态被引量：80

High-flux hemodialysis efficiently removes β_2-microglobin and improves inflammation status in maintain hemodialysis patients

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摘要目的前瞻性研究高通量血液透析对患者中分子毒素水平与炎症状态的影响。方法多中心、前瞻性、自身对照研究。136名维持性常规低通量血液透析患者,转换为高通量透析(Fresenius F60或FX60,超纯透析液)6个月。试验前(0个月)、后3个月、6个月分别采透析前血样测定β2微球蛋白(β2-MG)、超敏C反应蛋白(hsCRP)与胱抑素C(Cystatin C)水平。结果转换为高通量透析可以显著降低原低通量血液透析患者血β2-MG水平,从试验开始时0个月、3个月与6个月分别为(39.92±19.14)mg/L、(27.31±19.16)mg/L与(33.03±10.96)mg/L(P<0.001)。hsCRP水平也显著下降,分别为(11.23±21.77)mg/L、(8.37±11.61)mg/L与(8.82±11.66)mg/L(P=0.0412)。血cystatin C水平试验前后没有变化。结论高通量透析可以有效清除透析患者血液中的中分子毒素并减轻慢性微炎症状态。 Objective High-flux hemodialysis has been proven to be beneficial in reducing patients morbidity, even mortality, by removing middle molecules uremic toxins, while comparing with low-flux hemodialysis. Current prospective, self-controled study designed to detect whether changing to high-flux dialysis could efficiently reduce blood β2-microglobulin β2-MG levels and improve chronic inflammation status in patients with maintain low-flux hemodialysis. Methods 200 patients with maintain low-flux hemodialysis coming from 3 hemodialysis centers in Beijing were included. After switching to high-flux dialysis, all dialysis prescription kept unchanged except changed from using low-flux dialyzer to high-flux F60 or FX60 dialyzer. Ultrapure dialysate were implied. Predialysis blood samples were collected for detecting β2-MG, high-sensitivity C reactive protein （hsCRP） and cystatin C levels at 0, 3 and 6 months after entering the study. Results The plasma β2 MG levels decreasing significantly after shifting to high-flux dialysis, which were （39.92 ± 19.14） mg/L,（27.31 ±19.16） mg/L （P 〈 0.001 vs 0 month） and （33.03 ±10.96） mg/L （P 〈 0.001 vs 0 month） respectively at 0, 3 and 6 months. Plasma hsCRP levels were lowered as well, which were （11.23 ±21.77） mg/L, （8.37 ±11.61） mg/L （P=-0.0412） and （8.82 ±11.66） mg/L respectively at 0, 3 and 6 months. The levels of plasma Cystatin C kept unchanged during the study process. Conclusions The results show that shifting from low-flux to high-flux hemodialysis could efficiently remove β2 MG from blood, and improved inflammation status in maintain dialysis patients.

作者蔡砺刘惠兰吴华李冀军徐丰博汤天清殷培鲍云飞程叙扬左力

机构地区北京大学第一医院肾内科暨肾脏病研究所北京首都医科大学附属复兴医院肾内科卫生部北京医院肾内科中国人民解放军总医院第一附属医院肾内科

出处《中国血液净化》 2010年第1期25-28,共4页 Chinese Journal of Blood Purification

基金费森尤斯医药用品(上海)有限公司对本研究的资助

关键词血液透析高通量 Β2微球蛋白 C反应蛋白 Hemodialysis High-flux hemodialysis β2-microglobulin C reactive protein

分类号 R459.5 [医药卫生—治疗学]

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