中国血液净化

›› 2005, Vol. 4 ›› Issue (1): 16-18.

• 论著 • 上一篇    下一篇

透析相关性淀粉样病变的临床探讨

陈继红 桑晓红 王秀玲   

  1. 830000 新疆，新疆医科大学一附院肾病科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2005-01-12 发布日期:2005-01-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2005-01-12 Published:2005-01-12

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摘要：

目的 探讨透析相关性淀粉样病变的病因、发病机制 及其防治。方法 采用放射免疫法测定 血清β2-微球蛋白（β2-microglobulin, β2-MG），同时，常规检查血清肌酐、尿素氮和内生肌酐清除率，观察慢性肾衰竭不同阶段各指标的变化及血液透析（hemodialysis, HD）、血液灌流（hemoperfusion, HP ）对β2-MG水平的影响。结果 随肾功能衰竭程度日趋加重，血清β2-MG水平逐渐升高，血清β2-MG与血清肌酐、尿素氮呈正相关，而与内生肌酐清除率呈负相关，此外，长期血液透析治疗后，β2-MG在血液中蓄积的程度与透析时间呈正相关。血液透析后，β2-MG水平较透前稍下降，但无明显统计学意义。经血液灌流治疗后，β2-MG水平显著高于灌流前。结论 β2-MG增高可导致透析相关性淀粉样病变，探讨有效的清除β2-MG的方法对防治淀粉样病变具有极其重要的临床价值。

关键词: 血液透析, 血液灌流, β2微球蛋白, 透析相关性淀粉样病变

Abstract:

Objective To evalucate the pathogenesis,prevention and treatment of amyloidosis in longterm hemodialysis patients. Methods Serum β2-microglobulin was measured simultaneously in all patients using radioimmunoassay method. Meanwhile, serum creatinine、urea nitrogen and endogenous creatinine clearance were measured regularly to investigate the changes of these measurements in patients with different stages of chronic renal failure, and the effect of serum β2-microglobulin levels in patients with uremia during hemodialysis or hemoperfusion. Results With the increasing severity of renal failure, the concentrations of serum β2-microglobulin were gradually increased. There was a positive correlation between serum β2-microglobulin and creatinine or urea nitrogen,while serum β2-miroglobulin concentrations were inversely proportional to endogenous creatinine clearance. In addition, positive correlation was found between the levels of serum β2-microglobulin and the duration of maintaining dialysis in chronic hemodialysis patients.Serum β2-microglobulin levels were not markedly changed during hemodialysis. After the treatment of hemoperfusion, serum β2-microglobulin levels were elevated statisticaly. Conclusion The elevation of serum β2-microglobulin will lead to amyloidosis in long-term hemodialysis patients.In order to prevent and treat the amyloidosis, There is very important clinical value to find out a new way of effective removal of serum β2-microglobulin.

Key words: Hemoperfusion, β2-microglobulin, Dialysis-related amyloidosis 

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