中国血液净化

›› 2004, Vol. 3 ›› Issue (2): 78-81.

• 论著 • 上一篇    下一篇

三种血液净化方法对慢性肾衰竭患者血清瘦素清除的对照研究

娄探奇 王 成 石成刚 陈珠江 唐 骅 刘 迅
  

  1. 510630 广州，中山大学附属第三医院肾内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2004-02-19 发布日期:2004-02-19

  • Received:1900-01-01 Revised:1900-01-01 Online:2004-02-19 Published:2004-02-19

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摘要：

目的 比较不同血液净化方法对慢性肾衰竭维持性血液透析患者血清瘦素(Leptin)的清除。方法 符合入选标准的慢性肾衰竭维持性血液透析90例患者随机分为3组：AP组、HDF组、HD组，AP组接受树脂吸附联合血液透析治疗，HDF组接受血液透析滤过治疗，HD组接受血液透析治疗；治疗前后用放射免疫法测定血清瘦素水平。结果 ①AP组患者治疗后血leptin从(15.59±13.25)μg/L降至(9.72±10.11)μg/L，单次清除率为39.92% ，治疗前后比较有显著性差异（ P<0.05）；② HDF组患者治疗后血leptin从(18.89±14.93)μg/L降至(15.48±11.32)μg/L，经校正后leptin/Hct从(66.51±53.87)μg/L降至(50.33±41.30)μg/L，单次清除率为9.79%，治疗前后比较有显著性差异（ P<0.05）；③ HD组治疗后血leptin从(16.08±12.09)μg/L降至(15.60±11.24)μg/L，经校正后leptin/Hct从(58.47±47.37)μg/L降至(54.52±39.38)μg/L，治疗前后无显著性差异（ P>0.05）。结论 ①树脂吸附能有效清除 leptin，单次清除率达39.92%，清除率明显高于血液透析和血液透析滤过。②血液透析滤过也能清除leptin。③血液透析不能有效清除leptin。

关键词: 慢性肾功能衰竭, 血液透析, 血液透析滤过, 树脂吸附器, 瘦素

Abstract: Objective To investigate the effect of different purification techniques on serum leptin of chronic hemodialysis patients. Methods Ninety patients were randomly devided into two groups(AP group,HDF group and HD group). Patients in AP group were treated with the therapy of resin absorptive devices associated hemodialysis, hemodiafiltration for patients in HDF group and hemodialysis for patients in HD group. Blood routine examination, serum albumin, globulin, blood urea nitrogen, creatinine and leptin were measured before and after these treatments, vital signs and side effects were recorded during hemodialysis. Results ①Serum leptin in AP group decreases from (15.59±13.25)μg/L to 9.72±10.11(μg/L),which show statistically difference（P<0.05）, single clearance rate is 39.92%;② The concentration of leptin decrease from (18.89±14.93)μg/L to (15.48±11.32)μg/L in HDF group,the changes of leptins between before and after therapy were not statistically different, a single clearanc rate is 9.79%,While the concentration of leptin/Hct decreased from (66.51±53.87)μg/L to (50.33±41.30)μg/L, these changes showed statistically difference. ③The concentration of leptin decreased from (16.08±12.09)μg/L to (15.60±11.24)μg/L in HD group. The concentration of leptin/hct decreased from (58.47±47.34)μg/L to (54.52±39.28)μg/L, both changes between before and after therapy were not statistically different in HD group. All patients can tolerate these therapies. Conclusions Leptin absorptive devices can safely and effectively clear leptin, while hemodialysis can not lower serum leptin.

Key words: Hemodialysis, Hemodiafiltration, Resin absorptive devices, Leptin

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