中国血液净化

中国血液净化

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探讨高通量血液透析对维持性血液透析患者皮肤瘙痒及部分生化指标的影响

高秀,薄天慧,赵伟   

  1. 北京大学首钢医院肾内科
  • 出版日期:2013-05-12 发布日期:2013-07-01
  • 通讯作者: 高秀 snbjdxsgyy@163.com

Impacts of high flux hemodialysis on skin pruitus and some biochemical indexes in maintenance hemodialysis patients

  • Online:2013-05-12 Published:2013-07-01

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摘要： 【摘要】目的 研究高通量血液透析对维持性血液透析患者皮肤瘙痒及部分生化指标的影响。方法 采用前瞻性、自身对照研究。44例常规低通量血液透析患者，转换为高通量透析(Fresenius FX60-FX80，超纯透析液)治疗1 年。采用单因素方差分析比较试验前(0 月)、试验后6 个月与试验后12个月皮肤瘙痒程度，及透析后血肌酐(Cr)、尿素氮(BUN)、尿酸(UA)、血磷(P)、血钙(Ca)、全段甲状旁腺激素(iPTH)、白蛋白(ALB)、C-反应蛋白(CRP)、血红蛋白(Hb)、红细胞压积(Hct%)等指标水平的变化。 结果 高通量透析6、12 个月后较低通量透析时患者皮肤瘙痒症状明显改善，差异有统计学意义(5±2 分，4 ±2 分比7 ±3 分，F=5.960, P=0.000)，且两两比较显示高通量透析后12个月与6个月比较，皮肤瘙痒评分亦存在差异(5±2分，4±2分，P =0.000)。血 BUN、Cr、UA、Ca等生化指标在转化为高通量透析后，与低通量时比较，差异无统计学意义(P ＞0.05)；但CRP、ALB、iPTH、P、Hb、Hct%等指标在2种透析状态下有明显不同，差异有显著性(P＜0.05)。
结论 高通量透析能减轻患者的皮肤瘙痒，降低炎症指标，改善贫血和钙磷代谢紊乱，进而可能会提高血液透析患者的生存质量。

关键词: 高通量血液透析, 皮肤瘙痒, 生化指标

Abstract: 【Abstract】Objective To study the effects of high flux hemodialysis on skin pruitus and some biochemical indexes in hemodialysis patients. Methods The study was perspective and self-controlled. A total of 44 patients on preservation low flux hemodialysis were selected. After changing to high flux dialysis, dialysis prescription was unchanged except the change of dialyzer. Ultrapure dialysate was implied. To compare the skin pruitus, afterdialysis serum creatinine (Cr), blood urea nitrogen (BUN), uric acid (UA), serum phosphorus (P), calcium (Ca), intact parathyroid hormone (iPTH), albumin ( ALB ) , C – reactive protein (CRP) , hemoglobin (Hb),hematocrit(Hct%)level before changing to high flux hemodialysis and after 6,12months entering this study respectively by One-way ANOVA. Results The skin pruitus was improved significantly after changing to high flux hemodialysis 6 and 12 months (F=5.960，P=0.000). There were no differences of serum Cr, BUN, UA, Ca before and after changing to high flux hemodialysis (P＞0.05). But the differences of serum Hb, Hct%, ALB, iPTH, P，CRP were significantly before and after 6,12 months entering the study (P＜0.05). Conclusion The study show that using high flux
hemodialysis can improve skin pruritus, microinflammatory state, anima, abnormal calcium and phosphorus metabolism and life quality in hemodialysis patients probably.

Key words: High flux hemodialysis, Skin pruritus, Biochemical indexes