中国血液净化

中国血液净化 ›› 2013, Vol. 12 ›› Issue (09): 470-474.doi: 10.3969/j.issn.1671-4091.2013.09.00

• 临床研究 • 上一篇    下一篇

血液透析联合血液灌流对尿毒症中、大分子毒素清除与瘙痒症状疗效的研究

黄泳璋1,肖洁2,徐米清3   

  1. 1. 广州医学院第一附属医院
    2. 广州医学院第一附属医院肾内科
    3. 广州医学院第二附属医院肾内科
  • 收稿日期:2013-04-17 修回日期:2013-07-07 出版日期:2013-09-12 发布日期:2013-09-12
  • 通讯作者: 徐米清 gyeyxu@163.com E-mail:gyeyxu@163.com

A research of Macromolecules toxin removal and clinical efficacy of pruritus of hemodialysis combined with hemoperfusion on uremia patients

  • Received:2013-04-17 Revised:2013-07-07 Online:2013-09-12 Published:2013-09-12

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摘要： 【摘要】 目的 观察血液透析联合血液灌流对尿毒症毒素的清除与治疗的效果。 方法 选择尿毒症维持性血液透析（MHD)患者40例，随机分为血液透析(HD)组和血液透析联合血液灌流 (HD+HP)组，每组20例，分别对两组患者观察期治疗前后血晚期糖基化终末产物（AGEs）、同型半胱氨酸（Hcy）、甲状旁腺素（PTH）、β2 -微球蛋白（?2-MG）进行测定，临床观察两组治疗对尿毒症合并顽固性瘙痒的疗效并分析测定指标的变化与合并症的变化的相关性。 结果 HD+HP组治疗12周后血AGEs、Hcy、PTH、β2-MG指标较HD组治疗12周后低， P0.05（依次为0.867,0.054,0.727）。血PTH、β2-MG降低与皮肤瘙痒症状缓解情况之间的rs=0～1,P<0.05（依次为0.045,0.037）。 结论 血液透析联合血液灌流能有效清除维持性血液透析患者血AGEs、Hcy、PTH、β2-MG等中大分子物质；并能有效缓解MHD患者顽固性瘙痒合并症，这与其对PTH和β2-MG的有效清除有关。

关键词: 【关键词】血液透析, 血液灌流, 尿毒症

Abstract: A research of Macromolecules toxin removal and clinical efficacy of pruritus of hemodialysis combined with hemoperfusion on uremia patients HUANG Yong-zhang , XIAO Jie , XU Mi-qing . Department of Nephrology , The First Affiliated Hospital of Guangzhou Medical College ,Guangzhou 510120 , China Corresponding author：XU Mi-qing , Email: gyeyxu@163.com [ Abstract ] Objective To observe the effect of hemodialysis combined with hemoperfusion on uremic treatment effect. Methods 40 cases of maintenance hemodialysis (MHD) patients with uremia were randomly divided into hemodialysis ( HD ) group and hemodialysis combined with hemoperfusion ( HD+HP ) group. There were 20 cases in each group. Advanced glycation end products( AGEs ), homocysteine( Hcy ), parathyroid hormone( PTH ), β 2-Microglobulin( beta 2-MG ) of all patients were tested before and after the first treatment, before and after 12 weeks of treatment during serum. The efficacy of itching on MHD patients with uremia of both group were clinical observed. The correlation of changes of indexes and complications were analyzed. Results AGEs, Hcy, PTH,β 2-MG index in HD+HP group were lower than that of HD group after 12 treatments, P 0.05（0.867,0.054,0.727 in turn）. rs =0 ~ 1 between the reducing of PTH and β 2-MG and the remission of skin itching, P<0.05（0.045,0.037 in turn）. Conclusion HD+HP can effectively remove AGEs, Hcy, PTH and β 2-MG and remarkably release intractable pruritus in MHD patients. Level of blood PTH and β2-MG had positive correlation with uremic pruritus symptom.

Key words: [ keyword ] hemodialysis, hemoperfusion, uremia