中国血液净化

›› 2011, Vol. 10 ›› Issue (3): 125-128.doi: 10.3969/j.issn.1671-4091.2011.03.00

• 临床研究 • 上一篇    下一篇

应用FX60透析器对维持性血液透析患者慢性并发症的影响

李月红 晓 明 王 茹 燕 宇 檀 敏 王 梅   

  1. 北京大学人民医院肾内科
  • 收稿日期:2010-11-29 修回日期:1900-01-01 出版日期:2011-03-12 发布日期:2011-03-12
  • 通讯作者: 王 梅

The application of FX60 dialyser on chronic complications in maintenance hemodialysis patients

LI Yue-hong, XIAO Ming, WANG Ru, YAN Yu, TAN Min, WANG Mei   

  1. Department of Nephrology, Peking University People’s Hospital, Beijing 100044, China
  • Received:2010-11-29 Revised:1900-01-01 Online:2011-03-12 Published:2011-03-12

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摘要： 目的 探讨应用高通量透析器(FX60)对维持性血液透析患者慢性并发症的影响。 方法 30例透析龄大于2年的稳定维持性血液透析患者，年龄28～78岁，分别使用低通量和高通量透析器(FX60)透析1年，观察并比较血压、血红蛋白、总蛋白、白蛋白、血脂、全段甲状旁腺激素、尿素清除指数(Kt/V)、血钙、磷、钙磷乘积和血 2微球蛋白清除率的变化。 结果 低通量和高通量透析对小分子物质清除差异无统计学意义(P＞0.05)。使用FX60透析器行高通量透析1年后，患者血红蛋白由(103.9±18.1)g/L升至(111.8±11.5)g/L，全段甲状旁腺激素由(525.2±695.6)pg/ml下降到(437.3±417.2)pg/ml，透析前平均动脉压自(106.1±7.5)mm Hg下降到(104.5±7.3)mm Hg，高密度脂蛋白由(0.91±0.27)mmol/L升至(1.02±0.28)mmol/L，差异均有统计学意义(均P＜0.05)；而低通量透析上述指标无明显变化。FX60透析器单次透析血 2微球蛋白清除率为(35.9±3.8)%。 结论 用FX60透析器行高通量透析有利于清除中分子物质，改善透析患者的肾性贫血、高血压和继发性甲状旁腺功能亢进。

关键词: 维持性血液透析, 高通量透析, FX60透析器, 2微球蛋白

Abstract: Objective To investigate the application of FX60 dialyser on chronic complications in maintenance hemodialysis patients. Methods A total of 30 patients aged from 28 to 78 years old and on hemodialysis for more than 2 years were switched to FX60 dialyzer for hemodialysis for one year. Their clinical and biochemical indicators, including blood pressure, hemoglobin, albumin, intact parathyroid hormone (iPTH), calcium, lipids, calcium and phosphorus product, Kt/V and β2-MG clearance rate, were obtained before and after the application of FX60 dialyser. Results After the dialysis with FX60 dialyser for one year, hemoglobin increased from 103.9±18.1g/l to 111.8±11.5g/l (P＜0.05), iPTH declined from 525.2±695.6pg/ml to 437.3±417.2pg/ml (P＜0.05), mean arterial blood pressure lowered from 106.1±7.5mmHg to 104.5±7.3mmHg (P＜0.05), and high-density lipoprotein (HDL) increased from 0.91±0.27mmol/l to 1.02±0.28mmol/l (P<0.05). There were no significant differences in clearance rates for small molecules between low-flux dialysis and high-flux dialysis. β2-MG clearance rate was 35.9±3.8% after one dialysis session using FX60 dialyzer. Conclusion High-flux hemodialysis with FX60 dialyser effectively improves β2-MG clearance, renal anemia, hypertension, and secondary hyperparathyroidism in maintenance hemodialysis patients.

Key words: High-flux hemodialysis, FX60 dialyser, β2-microglobulin