摘要
目的:比较不同血液净化技术对慢性肾功能衰竭(肾衰)维持性血液透析患者血清甲状旁腺素(iPTH)、β2-微球蛋白(β2-MG)的清除效果。方法:选择血液透析中心符合入选标准的60例慢性肾衰竭维持性血液透析患者,随机分为血液灌流串联血液透析(HP+HD)组、在线血液透析滤过(On-line HDF)组、血液透析(HD)组,各组均为20例。在单次治疗前后及治疗1个月后取血用化学发光法测定血清iPTH水平,放射免疫法测定血清β2-MG水平。结果:单次治疗后,On-line HDF组血清β2-MG和iPTH均显著下降(P<0.01),HP+HD组血清iPTH显著下降(P<0.01),HD组血清β2-MG和iPTH均无显著下降(P>0.05);HD组和HP+HD组对β2-MG的清除率与On-line HDF组比较差异均有统计学意义(P<0.01),On-line HDF组和HP+HD组对iPTH的清除率与HD组比较差异均有统计学意义(P<0.01)。连续治疗1个月后,HP+HD组和On-line HDF组患者血清iPTH、β2-MG与治疗前比较差异均有统计学意义(P<0.01)。结论:血液灌流串联血液透析、在线血液透析滤过对中分子物质清除有效,长期应用可显著提高患者生活质量及生存率。血液透析不能有效清除iPTH、β2-MG,也不能有效缓解皮肤瘙痒症状。单次血液灌流串联血液透析能有效清除iPTH而对β2-MG无明显效果。
Objective：To determine the effects of different blood purification techniques on serum parathyroid hormone（iPTH） and β2-microglobulin（β2-MG） in the maintenance hemodialysis patients with chronic renal failure（CRF）.Methods： Sixty maintenance hemodialysis patients with chronic renal failure were enrolled and were randomly divided into tandem hemodialysis hemoperfusion（HP＋HD） group,on-line hemodiafiltration（On-line HDF） group,and blood hemodialysis（HD） group.Each group had 20 cases.Before and after single treatment,as well as in a month,serum levels of iPTH and β2-MG were measured by chemiluminescence and radioimmunoassay,respectively.Results： After single treatment,the levels of β2-MG and iPTH were significantly decreased in on-line HDF group.The serum level of iPTH was also significantly decreased in HP＋HD group.However,the levels of β2-MG and iPTH were not significantly decreased in HD group.A significant difference was found in the clearance rate of β2-MG between on-line HDF group and HD group,or between on-line HDF group and HP＋HD group.And compared to HD group,the clearance rate of iPTH was significantly increased in on-line HDF group and HP＋HD group.Serum iPTH and β2-MG levels in HP＋ HD group and on-line HDF group were significantly decreased after a month of treatment.Conclusion： HP＋HD and on-line HDF have an effect on the clearance of medium molecule substance.HD can not clear iPTH and β2-MG effectively.Moreover,single treatment by HP＋HD can remove iPTH effectively,but has no effect on the clearance of β2-MG.
出处
《包头医学院学报》
CAS
2011年第2期44-47,共4页
Journal of Baotou Medical College
