目的 探讨不同方式透析前、后尿毒血清对肾小管上皮细胞TGF-β1表达的影响。 方法 24例尿毒症透析患者随机分为血液透析(HD)、高通量血液透析(HFHD)、血液透析滤过（HDF）三组，分别于透析前后取患者血清，二乙酰一肟法测定透析前后尿素比值，评价三种透析方式的充分性；用透析前后患者血清刺激体外培养的肾小管上皮细胞株（HK-2细胞），然后用RT-PCR法检测HK-2细胞TGF-β1 mRNA表达，ELISA法检测HK-2细胞培养上清TGF-β1水平。 结果 三种透析方式的Kt/V值均大于1.2，达到充分透析的要求；HDF组透析后尿毒血清较透析前血清促HK-2细胞表达和分泌TGF-β1的作用减弱(P＜0.05)；而HD和HFHD组透析后与透析前比较，差异无统计学意义(P＞0.05）。 结论 HDF能更有效地清除尿毒血清中致前纤维化细胞因子表达的毒素，由此推测HDF可能更有效地延缓尿毒症患者肾间质纤维化的进展。

Objective To explore the effects of sera from different dialysis modalities on TGF-β1 expression in human renal tubular epithelial cells. Methods We randomly assigned 24 uremic patients into hemodialysis (HD), high-flux hemodialysis (HFHD) and hemodiafiltration (HDF) groups. Blood sample was collected from the patients before and after the dialysis. Diacetylmonoxime method was used to determine the ratio of urea nitrogen before and after the dialysis, from which Kt/V value was calculated and the adequacy of hemodialysis was estimated. HK-2 cells were cultured with the patient sera before and after dialysis. TGF-β1 mRNA in these cells was measured by RT-PCR, and TGF-β1 protein in cultured supernatant of HK-2 cells was determined by ELISA. Results The Kt/V values of the 3 blood purification methods exceeded 1.2, indicating the adequate hemodialysis. The sera after HDF showed less effects on TGF-β1 mRNA expression in HK-2 cells and less TGF-β1 secretion from the cells (P<0.05) than the sera before HDF. However, these changes were not found from sera before and after HD and HFHD (P>0.05). Conclusion HDF can effectively eliminate the uremic toxin inducing fibrosis-associated cytokine expression. Therefore, we presume that HDF is capable to efficiently postpone the interstitial fibrosis in kidney.