摘要
目的:探讨高通量血液透析治疗肾性贫血的疗效。方法:维持血液透析患者73例。随机分为低通量透析组(LFHD组)和高通量透析组(HFHD组),共治疗6个月。监测患者血常规、白蛋白(albumin,Alb)、全段甲状旁腺激素(intact parathyroidism hormone,iPTH)、C-反应蛋白(C-reactive protein,CRP)、β2-微球蛋白(β2-microglobulin,β2-MG)等参数。记录留取静脉血前4周重组人促红素(recombinant human erythropoietin,r-HuEPO)的应用总量,以每周应用总量同血细胞比容(hematoccrit,Hct)的比值(EPO/Hct)作为评价r-HuEPO低反应的指标。比较两组患者上述指标的差别。结果:(1)LFHD组患者低通量普通透析治疗6月后,Hb、Hct、EPO/Hct、Alb、iPTH、CRP、β2-MG较试验前无明显变化(P>0.05)(2)HFHD组患者高通量血液透析治疗6个月后,Alb、Hb、Hct较试验前升高(P<0.05);EPO/Hct、CRP、β2-MG较治疗前减低(P<0.05);iPTH较治疗前略减低(P>0.05)。(3)试验结束时,HFHD组患者Alb较LFHD组高(P<0.05);Hb、Hct较LFHD组试验结束略高(P>0.05);EPO/Hct、CRP、β2-MG较LFHD组试验结束时低(P<0.05);iPTH较LFHD组试验结束时低(P>0.05)。(4)HFHD组患者治疗后Alb增加较LFHD明显,HFHD组患者治疗后CRP、MG、EPO/Hct减低较LFHD明显,差异具有统计学意义(P<0.05)。结论:高通量血液透析可以加强尿毒症患者中分子毒素的清除,改善患者的微炎症状态和营养不良,有利于改善EPO低反应性。
Objective：To observe the effect of high flux hemodialysis on the treatment of renal anemia. Methods ：73 patients with regular hemodialysis treatment were randomly divided into two groups ： low flux hemodialysis group and high flux hemodialysis group. The treatment lasted for 6 months. A series of biochemical tests were performed before and after treatment in two groups, such as blood routine, albumin （Alb）, C -reactive protein （CRP）, β2 -microglobulin （β2 -MG）. Record the total applied amount of r - HuEPO in 4 weeks before blood collection and the ratio of the applied amount of r - HuEPO per week and Hct as the evaluation in- dicator of low response for r - HuEPO. Results：Mter treatment for 6 months, Hb .Hct.EPO/Hct,Alb.iPTH.CRP,β2 - MG in LFHD group had no significant change（P 〉 0.05 ）o After treatment for 6 months, Alb,Hb.Hct in B group were increased （P 〈 0.05 ）, EPO/Hct,CRP.13z -MG in HFHD groups were decreased（P 〈 0.05 ）,iPTH in HFHD groups were decreased slightly（P 〉 0.05 ）. After treatment for 6 months, Alb in HFHD group were higher compare to LFHD group （ P 〈 0.05 ）, Hb, Hct in HFHD group were higher slightly compare to LFHD group （P 〉 0.05 ）, EPO/Hct..CRP,β2 -MG in HFHD groups were lower compare to LFHD group （P 〈 0.05）. The difference of Alb before and after treatment in HFHD group was higher than that of LFHD group, The difference of CRP,MG.EPO/Hct before and after treatment in HFHD group was lower than that of LFHD group （P 〈 0.05 ）. Conclusion：High flux hemodialysis strengthen to clear middle molecule toxins in blood, improve microinflammation condition, malnutrition and low effect of r - HuEPO on the treatment of renal anemia.
出处
《中国中西医结合肾病杂志》
2013年第2期114-116,共3页
Chinese Journal of Integrated Traditional and Western Nephrology
基金
国家"十二五"支撑计划项目(No.2011BAI10B08
2011BAI10B07)
关键词
血液透析
肾性贫血
高通量透析
Hemodialysis Renal anemia High flux hemodialysis
