CAJ | 학술논문

目的探讨组合型人工肾血液灌流串联血液透析对维持性透析者服用活性维生素D3时高血磷和高血清甲状旁腺激素的影响.方法随机选择42例接受维持性血液净化治疗者,按血液净化方法不同分为血液透析组(n=20)和血液灌流串联血液透析组(n=22),分别治疗4周.在治疗前后检测两组受试者血钙、血磷、血清甲状旁腺激素和C反应蛋白水平.采用t检验进行数据统计.结果血液透析组血磷水平较治疗前有所升高[(2.2±0.4)vs(2.3±0.5)mrnol/L],但差异无统计学意义；甲状旁腺激素较治疗前明显下降[(340±36) vs(310±25) ng/L],差异有统计学意义(P＜0.05).治疗后,血液灌流串联血液透析组血磷[(2.2±0.6)vs(1.7±0.4) mmol/L]、甲状旁腺激素水平[(355±38) vs (285±29) ng/L]和血清C反应蛋白水平[(3.3±4.8)vs(1.5±3.8)mg/L]均有所下降,差异有统计学意义(P＜0.05).两组血钙水平未见明显改变.结论组合型人工肾血液灌流串联血液透析可减轻维持性血透者磷负荷,改善钙磷代谢紊乱和微炎症状态,有效避免使用活性维生素D3时诱发的高磷血症.
목적 탐토조합형인공신혈액관류천련혈액투석대유지성투석자복용활성유생소D3시고혈린화고혈청갑상방선격소적영향.방법 수궤선택42례접수유지성혈액정화치료자,안혈액정화방법불동분위혈액투석조(n=20)화혈액관류천련혈액투석조(n=22),분별치료4주.재치료전후검측량조수시자혈개、혈린、혈청갑상방선격소화C반응단백수평.채용t검험진행수거통계.결과 혈액투석조혈린수평교치료전유소승고[(2.2±0.4)vs(2.3±0.5)mrnol/L],단차이무통계학의의；갑상방선격소교치료전명현하강[(340±36) vs(310±25) ng/L],차이유통계학의의(P＜0.05).치료후,혈액관류천련혈액투석조혈린[(2.2±0.6)vs(1.7±0.4) mmol/L]、갑상방선격소수평[(355±38) vs (285±29) ng/L]화혈청C반응단백수평[(3.3±4.8)vs(1.5±3.8)mg/L]균유소하강,차이유통계학의의(P＜0.05).량조혈개수평미견명현개변.결론 조합형인공신혈액관류천련혈액투석가감경유지성혈투자린부하,개선개린대사문란화미염증상태,유효피면사용활성유생소D3시유발적고린혈증.
Objective To evaluate the effects of hybrid renal replacement therapy (HRRT) on metabolic disorder of calcium or phosphate and micro-inflammation in maintenance hemodialysis (MHD) patients treated with a maintenance dose of 1,25-(OH)VitD3.Methods A total of 42 MHD patients were randomly assigned to group A and group B.Those in group A were treated with hemodialysis,while the subjects in group B were treated with combined hemodialysis-hemoperfusion.All the participants took a maintenance dose of 1,25-(OH)VitD3(0.25 U/d) and were followed up for 4 weeks.The serum levels of serum calcium,phosphorus,intact parathyroid hormone (iPTH) and C-reactive protein (CRP) were detected at baseline and post-treatment.Student' s t test was used for data analysis.Results The level of serum phosphorus was elevated following treatment ((2.2 ± 0.4) vs (2.3 ± 0.5) mmol/L) in group A,although the difference was not statistically significant.In group B,the level of serum phosphorus was significantly decreased post treatment ((2.2±0.6) vs (1.7 ± 0.4) mmol/L,P ＜ 0.05).The serum level of calcium didn' t significantly changed in two groups,while serum iPTH was significantly down regulated after the treatment (group A:(340± 36) vs (310 ± 25) ng/L,P ＜ 0.05; group B:(355 ± 38) vs (285 ± 29) ng/L,P ＜ 0.01).CRP was significantly reduced after HRRT in group B (3.3 ± 4.8) vs (1.5 ± 3.8) mg/L,P ＜ 0.01).Conclusions HRRT can alleviate metabolic disorder of calcium or phosphate and microinflammation in maintenance hemodialysis patients treated with a maintenance dose of 1,25-(OH)VitD3.