不同血液净化方法对尿毒症患者血β2-微球蛋白清除观察

›› 2009, Vol. 8 ›› Issue (3): 152-154.

不同血液净化方法对尿毒症患者血β2-微球蛋白清除观察

张启蒙李杰阿斯亚梁富冀福英

北京中关村医院血液透析室

收稿日期:2008-09-23 修回日期:1900-01-01 出版日期:2009-03-12 发布日期:2009-03-12

Observation of various hemodialysis methods on clearance of ?-microglobulin in uremic patients

ZHANG Qi-meng, LI Jie, A Si-ya, LIANG Fu, JI Fu-ying

Hemodialysis Center, Beijing Zhong Guan Cun Hospital, Beijing 100191, China

Received:2008-09-23 Revised:1900-01-01 Online:2009-03-12 Published:2009-03-12

摘要/Abstract

摘要： 【摘要】目的观察普通血液透析(HD)、血液透析滤过(HDF)、血液透析加灌流(HP+HD)及可复用高通量血液透析(HFDR)对尿毒症病人血β2-微球蛋白(β2M)清除情况。方法选择我院长期血液透析患者60人，将病人随机分为HD、HDF、HP+HD、HFDR组，前瞻性对照观察各组病人治疗前后血液及排出液中β2M的变化. 结果 ① 常规HD治疗后病人血β2M明显升高(P＜0.01），常规HP+HD治疗后病人血β2M升高(P＜0.05），HDF及HFDR治疗后血β2M明显下降(P＜0.01）；② HDF、HFDR组排出液β2M浓度明显高于HD组(P＜0.01）；③ HFDR组在复用十次治疗后血β2M仍然明显下降(P＜0.01），应用HFDR组一年以后病人透析前血β2M明显下降(P＜0.01)。结论普通HD及普通HP+HD不能有效清除病人血β2M；HDF及HFDR可有效清除病人血β2M。长期应用HFDR可有效持续降低尿毒症维持性血液透析病人血β2M水平(P＜0.01)。

关键词: 血液透析, 血液透析滤过, 血液灌流, 可复用高通量血液透析, β2-微球蛋白

Abstract: 【Abstract】 Objective To observe the effect of hemodialysis (HD), hemodiafiltration (HDF), hemodialysis plus hemoperfusion (HP+HD) and high flux dialysis reuse (HFDR) on clearance of β2-microglobulin (β2M) in uremic patients. Methods We randomly assigned 60 patients treated with hemodialysis for a long period of time in this hospital into HD, HDF, HP+HD or HFDR group, and prospectively observed the changes of β2M in serum and in flow-through dialysate before and after a session. Results Serum β2M increased significantly after treatment in HD group (P＜0.01) and HP+HD group (P＜0.05). However, serum β2M decreased significantly after treatment in HDF and HFDR groups (P<0.01). β2M concentration in flow-through dialysate was higher in HDF and HFDR groups than in HD group (P<0.01). In HDFR group, serum β2M remained lower after the reuse for 10 times, and the serum β2M before dialysis session decreased significantly (P<0.01) after HFDR for 1 year. Conclusion Effective clearance of β2M in serum can be seen in patients treated with HDF and HFDR but not in those treated HD and HP+HD. Long-term application of HFDR can effectively and persistently lower serum β2M (P＜0.01) in maintenance hemodialysis uremic patients.

Key words: Hemodiafiltration, Hemoperfusion, High flux dialysis reuse

张启蒙李杰阿斯亚梁富冀福英. 不同血液净化方法对尿毒症患者血β2-微球蛋白清除观察[J]. , 2009, 8(3): 152-154.

ZHANG Qi-meng;LI Jie;A Si-ya;LIANG Fu;JI Fu-ying. Observation of various hemodialysis methods on clearance of ?-microglobulin in uremic patients[J]. , 2009, 8(3): 152-154.