【摘要】目的 前瞻性研究高通量血液透析对患者中分子毒素水平与炎症状态的影响。方法 多种心、前瞻性、自身对照研究。200名维持性常规低通量血液透析患者，转换为高通量透析(Fresenius F60或FX60, 超纯透析液)6月。试验前(0月)、后3月、6月分别采透析前血样测定β2微球蛋白(β2M)、超敏C反应蛋白(hsCRP)与胱抑素C(Cystatin C)水平。结果 转换为高通量透析可以显著降低原低通量血液透析患者血β2M水平，从试验开始时0月、3月与6月分别为(39.92±19.14)mg/L、(27.31±19.16)mg/L与(33.03±10.96)mg/L( P＜0.001)。hsCRP水平也显著下降，分别为(11.23±21.77)mg/L、(8.37±11.61)mg/L(P=0.0412)与(8.82±11.66)mg/L。血Cystatin C 水平试验前后没有变化。结论 高通量透析可以有效清除透析患者血液中的中分子毒素并减轻慢性微炎症状态。

【Abstract】 Background High-flux hemodialysis has been proven to be beneficial in reducing patients morbidity, even mortality, by removing middle molecules uremic toxins, while comparing with low-flux hemodialysis. Current prospective, self-controled study designed to detect whether changing to high-flux dialysis could efficiently reduce blood 2-microglobulin (2M) levels and improve chronic inflammation status in patients with maintain low-flux hemodialysis. 200 patients with maintain low-flux hemodialysis coming from 3 hemodialysis centers in Beijing were included. After switching to high-flux dialysis, all dialysis prescription kept unchanged except changed from using low-flux dialyzer to high-flux F60 or FX60 dialyzer. Ultrapure dialysate were implied. Predialysis blood samples were collected for detecting 2M, high-sensitivity C reactive protein (hsCRP) and cystatin C levels at 0, 3 and 6 months after entering the study. The plasma 2M levels decreasing significantly after shifting to high-flux dialysis, which were (39.9219.14) mg/L、(27.3119.16) mg/L (P＜0.001 vs 0 month) and (33.0310.96) mg/L (P＜0.001 vs 0 month) respectively at 0, 3 and 6 months. Plasma hsCRP levels were lowered as well, which were (11.2321.77) mg/L、(8.3711.61) mg/L (P=0.0412) and (8.8211.66) mg/L respectively at 0, 3 and 6 months. The levels of plasma Cystatin C kept unchanged during the study process. The results show that shifting from low-flux to high-flux hemodialysis could efficiently remove 2M from blood, and improved inflammation status in maintain dialysis patients.