摘要
目的 :探讨联机血液透析滤过 (联机HDF)治疗尿毒症皮肤瘙痒的临床效果和机制。方法 :应用Frese niusMedicalCare 4 0 0 8S血液透析滤过机进行联机HDF ,每周治疗 3次 ,每次 4h ,前稀释法 ,置换液量 6 5mL/ (kg·h) ,检测病人血清BUN、Cr、β2 -MG数值及皮肤瘙痒程度。结果 :联机HDF对普通透析 (HD)病人尿毒症皮肤瘙痒治疗有明显疗效 (P <0 0 1) ,有效率 72 %。部分缓解者联机HDF次数 χ=11 2 ,缓解者联机HDF次数 χ=15 6。联机HDF治疗 2 0次检测透析前血清BUN、Cr、β2 -MG数值与HD时相比较 ,血清BUN、Cr无明显变化 (P >0 0 5 ) ,β2 -MG明显降低 (P <0 0 5 )。结论 :联机HDF对尿毒症皮肤瘙痒治疗有效 ,其机制可能是较多地清除了尿毒症患者体内诸如 β2 -MG等中大分子毒性物质。
Objective:To explore clinical effect and mechanism of on-line hemodifiltration (on-line HDF)treating uremic pruritus.Method:Patients with uremic pruritus were treated by on-line hemodifiltrator (Fresenius Medical Care 4008 S),3/w × 4 h,by predilution method with 65 ml/(kg·h) solution exchanged.Serum BUN,Cr,β 2-MG were detected and cutaneous itching was checked after the therapy.Results:Remarkable therapeutic results with effective rate of 72% were received in the treated patients (P<0.01).On average,partially remitted patients received 11.2 on-line HDF therapies and completely remitted patients received 15.6 therapies.There was no difference in contents of serum BUN, Cr after 20 on-line HDF therapies (P>0.05),but contents of β 2-MG decreased obviously (P<0.05).Conclusion:On-line HDF is effevctive to uremic pruritus through eliminating macromolecular toxic substances such as β 2-MG,etc.
出处
《九江医学》
2003年第1期4-5,共2页
Jiujiang Medical Journal
