中国血液净化

›› 2011, Vol. 10 ›› Issue (02): 71-73.doi: 10.3969/j.issn.1671-4091.2011..00

• 临床研究 • 上一篇    下一篇

维持性血液透析患者应用不同血液净化方式对残余肾功能影响的临床研究

赵静瑜 吴 际 王乃平   

  1. 河南省开封市第一人民医院血液净化室
  • 收稿日期:2010-08-18 修回日期:1900-01-01 出版日期:2011-02-12 发布日期:2011-02-12
  • 通讯作者: 王乃平

The impact of different blood purification methods on residual renal function among maintenance hemodialysis patients

ZHAO Jing-yu, WU Ji, WANG Nai-ping   

  1. Blood purification Division The First Hospital of Kaifeng City, Henan 475000, China
  • Received:2010-08-18 Revised:1900-01-01 Online:2011-02-12 Published:2011-02-12

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摘要： 目的 研究不同血液净化方式对维持性血液透析(maintenance hemodialysis,MHD)患者残余肾功能(residual renal function,RRF)的影响。 方法 选取河南省开封市第一人民医院血液净化室常规血液透析的尿毒症患者，将这些患者依随机样表随机分为3组：低通量血液透析(low flux hemodialysis,LFHD)组、高通量血液透析(high flux hemodialysis,HFHD)组和血液透析联合血液灌流(hemodialysis and hemoperfusion,HD+HP)组，分别使用F6、F60透析器、F6透析器联合HA130血液灌流器，分别于入选时、治疗6个月后采集患者血尿标本，计算出RRF，观察其变化情况。并检测了入组时及 6个月后3组患者透析前胆固醇、甘油三酯、 2微球蛋白及血磷浓度，研究HFHD、HD+HP 和 LFHD 对血脂、 2微球蛋白及血磷的影响。 结果 入选时LFHD组、HFHD组和HD+HP组患者RRF差异无统计学意义(P＞0.05)，治疗后3组患者RRF均较入选时明显减低(P＜0.05)。治疗后HFHD组和HD+HP组较 LFHD 组患者RRF差异有统计学意义(P＜0.05)，HFHD组和HD+HP组差异无统计学意义(P＞0.05)。入组时3组患者透析前血脂、 2微球蛋白及血磷差异均无统计学意义(P＞0.05)。6 个月后 HFHD、HD+HP 组患者透析前血脂、 2微球蛋白及血磷明显低于LFHD组，差异有统计学意义(P＜0.05)；HFHD组和HD+HP组之间差异无统计学意义(P＞0.05)。 结论 血液透析患者透析过程中RRF均有下降，但HFHD及HD+HP下降率明显低于LFHD，提示HFHD及HD+HP较LFHD能更好地保护RRF。HFHD及HD+HP均可以降低血液透析患者血脂、 2微球蛋白及血磷水平。

关键词: 血液透析, 残余肾功能, 高通量血液透析, 低通量血液透析, 血液透析联合血液灌流

Abstract: Objective To study the impact of different blood purification methods on residual renal function (RRF) among maintenance hemodialysis (MHD) patients. Methods Uremic patients on hemodialysis in the Blood Purification Division of this hospital were randomly divided into three groups, low flux hemodialysis (LFHD) group, high-flux hemodialysis (HFHD) group and hemodialysis combined hemoperfusion (HD+HP) group using F6 dialyzer, F60 dialyzer, and F6 dialyzer combined with HA130 blood perfusion dialyzer, respectively. Before the treatment and after the treatments for 6 months, blood and urine specimens were collected, RRF was calculated, and cholesterol, triglycerides, β2-microglobulin (β2-MG) and serum phosphate levels were examined. Results RRF had no significant difference among the 3 groups (P>0.05) before the treatment. After the treatment, RRF was significantly lower than that before the treatment in the 3 groups (P<0.05), RRF was significantly different between HFHD and HD+HP groups and LFHD group (P<0.05), but had no difference between HFHD group and HD+HP group (P>0.05). Serum cholesterol, triglycerides, β2-MG and phosphate levels showed no differences among the 3 groups before the treatment (P> 0.05), became significantly lower in HFHD and HD+HP groups than in LFHD group after the treatment for 6 months (P<0.05), but had no differences between HFHD group and HD+HP group after the treatment for 6 months (P> 0.05). Conclusion RRF declined in hemodialysis patients after dialysis. The decline rate was lower in HFHD and HD+HP groups than in LFHD group, suggesting that HFHD and HD+HP are better than LFHD in the protection of RRF. HFHD and HD+HP also reduced the blood lipids, β2-MG and serum phosphate levels in hemodialysis patients.

Key words: Residual renal function, High flux hemodialysis, Low flux hemodialysis, Hemodialysis and hemoperfusion