国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2011年
1期
13-17
,共5页
袁飞%刘国辉%郑东文%罗海凤
袁飛%劉國輝%鄭東文%囉海鳳
원비%류국휘%정동문%라해봉
心血管并发症%血液透析滤过%血液灌流%甲状旁腺素%肾素%血管紧张素Ⅱ
心血管併髮癥%血液透析濾過%血液灌流%甲狀徬腺素%腎素%血管緊張素Ⅱ
심혈관병발증%혈액투석려과%혈액관류%갑상방선소%신소%혈관긴장소Ⅱ
Cardiovascular complications%Hemodiafiltration HDF%Hemoperfusion%Parathyroid hormone%Renin%Angiotensin Ⅱ (Ang Ⅱ )
目的 比较不同血液净化方法对慢性肾功能衰竭(CRF)患者心血管稳定性的影响及其内在可能机制.方法 将90例CRF患者随机分为3组.A组(HD组)行每周3次标准血液透析(HD)治疗;B组(HDF组)行每周2次常规标准血液透析(HD)治疗和每周1次血液透析滤过(HDF)治疗;C组(HP组)行每周2次常规标准血液透析(HD)治疗和每周1次血液灌流(HP)联合血液透析(HD)治疗.每一方案治疗时间为10周,间隔2周,间隔期用Fresenius F6或F8行常规HD治疗,共观察6个月.比较三组患者透析过程中心血管并发症的发生率以及治疗后6个月甲状旁腺素(iPTH)、血浆肾素(RA)、血管紧张素Ⅱ(Ang Ⅱ)的变化.结果 透析过程中B组和C组患者心血管并发症发生率分别为11.3%、10.9%,较A组20.4%明显减少,治疗后iPTH、血浆肾素(RA)、血管紧张素Ⅱ(AngⅡ)较A组也均明显下降,但B组和C组间未见明显差异.结论 血液透析滤过和血液灌流治疗病人心血管稳定性更好,这可能与其能有效地清除血浆RA、AngⅡ、甲状旁腺素(iPTH)等中分子毒素有关,两者效果相当,而血液灌流由于操作简单,设备要求低,更易于基层临床普及.
目的 比較不同血液淨化方法對慢性腎功能衰竭(CRF)患者心血管穩定性的影響及其內在可能機製.方法 將90例CRF患者隨機分為3組.A組(HD組)行每週3次標準血液透析(HD)治療;B組(HDF組)行每週2次常規標準血液透析(HD)治療和每週1次血液透析濾過(HDF)治療;C組(HP組)行每週2次常規標準血液透析(HD)治療和每週1次血液灌流(HP)聯閤血液透析(HD)治療.每一方案治療時間為10週,間隔2週,間隔期用Fresenius F6或F8行常規HD治療,共觀察6箇月.比較三組患者透析過程中心血管併髮癥的髮生率以及治療後6箇月甲狀徬腺素(iPTH)、血漿腎素(RA)、血管緊張素Ⅱ(Ang Ⅱ)的變化.結果 透析過程中B組和C組患者心血管併髮癥髮生率分彆為11.3%、10.9%,較A組20.4%明顯減少,治療後iPTH、血漿腎素(RA)、血管緊張素Ⅱ(AngⅡ)較A組也均明顯下降,但B組和C組間未見明顯差異.結論 血液透析濾過和血液灌流治療病人心血管穩定性更好,這可能與其能有效地清除血漿RA、AngⅡ、甲狀徬腺素(iPTH)等中分子毒素有關,兩者效果相噹,而血液灌流由于操作簡單,設備要求低,更易于基層臨床普及.
목적 비교불동혈액정화방법대만성신공능쇠갈(CRF)환자심혈관은정성적영향급기내재가능궤제.방법 장90례CRF환자수궤분위3조.A조(HD조)행매주3차표준혈액투석(HD)치료;B조(HDF조)행매주2차상규표준혈액투석(HD)치료화매주1차혈액투석려과(HDF)치료;C조(HP조)행매주2차상규표준혈액투석(HD)치료화매주1차혈액관류(HP)연합혈액투석(HD)치료.매일방안치료시간위10주,간격2주,간격기용Fresenius F6혹F8행상규HD치료,공관찰6개월.비교삼조환자투석과정중심혈관병발증적발생솔이급치료후6개월갑상방선소(iPTH)、혈장신소(RA)、혈관긴장소Ⅱ(Ang Ⅱ)적변화.결과 투석과정중B조화C조환자심혈관병발증발생솔분별위11.3%、10.9%,교A조20.4%명현감소,치료후iPTH、혈장신소(RA)、혈관긴장소Ⅱ(AngⅡ)교A조야균명현하강,단B조화C조간미견명현차이.결론 혈액투석려과화혈액관류치료병인심혈관은정성경호,저가능여기능유효지청제혈장RA、AngⅡ、갑상방선소(iPTH)등중분자독소유관,량자효과상당,이혈액관류유우조작간단,설비요구저,경역우기층림상보급.
Objective To compare different blood purification techniques on cardiovascular stability in patients with chronic renal failure (CRF) and its inherent possible mechanism. Methods 90patients with CRF were randomly divided into 3 groups. Group A (HD Group) was applied 3 times per week hemodialysis (HD) treatment; Group B (HDF group) 2 times a week routine standard hemodialysis (HD)treatment and 1 time a week hemodiafiltration (HDF) treatment; Group C (HP group) 2 times a week routine standard blood dialysis (HD) treatment and 1 time a week hemoperfusion (HP) combined with hemodialysis (HD) treatment. The treatment time in every group is 10 weeks, after that there was an interval of 2 weeks with a Fresenius F6 or F8 routine HD treatment , the total time was 6 months. The incidence of cardiovascular complications in the three groups during dialysis, and parathyroid hormone (iPTH), plasma renin (RA),angiotensin Ⅱ (Ang Ⅱ ) changes after 6 months of treatment were compared. Results During dialysis,patients of groups B and C compared with group A significantly reduced cardiovascular complications( group B is 11.3%, group C is 10.9%, but group A is 20.4% ), after treatment plasma iPTH, renin (RA),angiotensin Ⅱ (Ang Ⅱ ) were also decreased significantly compared with group A, but the groups B and C had no significant difference. Conclusion Patients with Hemodialysis or hemoperfusion treatment have better cardiovascular stability, This may be associated with the effective removal of plasma RA, Ang Ⅱ , parathyroid hormone (iPTH) and other middle molecule toxins, both treatments have an equal effect due to simple operation and low equipment requirements, hemoperfusion is much easier to be carried out universally.
