高通量血液透析对慢性肾衰患者溶质清除效果观察及临床意义(1)
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[摘要] 目的：观察高通量透析对慢性肾功能衰竭(CRF)血透患者溶质的清除效果及临床意义。方法：选择42例维持性血液透析患者，治疗组和对照组各21例，治疗组采用面积为1.8 m2的高通量透析器，对照组采用面积为1.3 m2的普通透析器，连续观察12周，分析患者症状改善情况，并测定首次透析前及12周后的血β2微球蛋白(β2-M)、甲状旁腺素(PTH)、血磷(P)、清蛋白(Alb)、血肌酐(Scr)、血尿素氮(BUN)等指标。结果：高通量透析对血磷、β2微球蛋白、甲状旁腺素的清除与常规血液透析比较，差异有显著性；而血肌酐、血尿素氮、清蛋白下降无显著性差异。观察组患者皮肤瘙痒、肌肉痉挛、关节疼痛症状缓解明显。结论：高通量透析可以增加对较大分子毒素及血磷的清除，能有效改善患者的症状。
[关键词] 血液透析；高通量透析；血磷；甲状旁腺素；血β2微球蛋白
[中图分类号] R692.5[文献标识码]A [文章编号]1673-7210(2009)03(c)-032-02
Clinical observation of solute clearance using high-flux hemodialysis in the treatment of chronic renal failure patients
DING Yang, WANG Zhe, LI Fang
(The Fourth People's Hospital of Shenyang, Shenyang110031, China)
[Abstract] Objective: To observe the effect of solute clearance using high-flux hemodialysis in the treatment of chronic renal failure (CRF) patients. Methods: Forty-two maintenance hemodialysis patients were randomly divided into two groups (twenty-one patients each group): in treatment group high-flux dialysers (HFHD) were used, and in control group, low-flux dialysers (LFHD) were used. They were treated for 12 weeks. The clinical symptom, blood β2 microglobulin (β2-M), paratyyroid hormone (PTH), serum phosphate, albumin, serum creatinine (Scr), blood urea nitrogen (BUN) were determined respectively before and after the treatment. Results: The clearance of serum phosphate, β2-M and PTH in HFHD group increased remarkably after 12 weeks compared with the result in the LFHD group，the differences were significant. However, there was no significant difference between the two groups in the clearance of serum creatinine, blood urea nitrogen and albumin. In HFHD group, skin itching, muscle spasm and arthralgia were significantly improved. Conclusion: HFHD is better than LFHD in the clearance of larger molecules such as PTH, β2-M and serum phosphate. Therefore, clinical symptoms are effectively improved.
[Key words] Hemodialysis; High-flux dialysers; Serum phosphate; Paratyyroid hormone; Blood β2 microglobulin ......
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