中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2015年
4期
1-3
,共3页
弓晓丽%刘继红%张巍%赵银娥
弓曉麗%劉繼紅%張巍%趙銀娥
궁효려%류계홍%장외%조은아
维持性血液透析%残余肾功能%高通量血液透析%低通量血液透析%血液透析联合血液灌流
維持性血液透析%殘餘腎功能%高通量血液透析%低通量血液透析%血液透析聯閤血液灌流
유지성혈액투석%잔여신공능%고통량혈액투석%저통량혈액투석%혈액투석연합혈액관류
Maintenance hemodialysis%Residual renal function%High flux hemodialysis%Low flux hemodialysis%Hemodialysis combined with hemoperfusion
目的 探讨不同血液净化方式对维持性血液透析(MHD)患者残余肾功能(RRF)的影响.方法 将长治医学院附属和济医院于2010年5月至2013年7月收治的维持性血液透析患者126例,按照不同血液净化方式分为高通量血液透析(HFHD)组、低通量血液透析(LFHD)组和血液透析联合血液灌流(HD+ HP)组,每组42例.三组依次分别使用F60、F6透析器、F6透析器联合HA130血液灌流器治疗6个月,并采集患者治疗前后的血尿标本,计算RRF;同时对比分析治疗前后三组患者的三酰甘油、胆固醇、β2微球蛋白以及血磷浓度水平变化情况.结果 治疗6个月后,三组RRF均显著低于治疗前,差异有统计学意义(分别t=22.21、21.33、8.32,P均＜0.01);HFHD组和HD+ HF组的RRF下降率均显著低于LFHD组,差异有统计学意义(分别t=6.71、5.10,P均＜0.01);而HFHD组RRF与HD+ HF组比较差异未见统计学意义(P＞0.05).同时,治疗后HFHD组和HD+ HF组血磷、三酰甘油、β2微球蛋白及总胆固醇等水平均显著低于LFHD组,差异有统计学意义(分别t1=2.24,P＜0.05;t1=3.87,P＜0.01;t2=11.02,P＜0.01;t2=9.22,P＜0.01;t3=2.08,P＜0.05;t3=2.09,P＜0.05;t4=6.97,P＜0.01;t4=8.16,P＜0.01);而HFHD组血磷、三酰甘油、β2微球蛋白及总胆固醇等水平与HD+ HP组比较差异未见统计学意义(P＞0.05).结论 维持性血液透析患者在不同血液净化过程中残余肾功能均有下降,但HFHD组和HD+ HP组对残余肾功能的不良影响相对较小,表明HFHD组和HD+ HP组可以最大限度地保护残余肾功能,值得在临床中推广使用.
目的 探討不同血液淨化方式對維持性血液透析(MHD)患者殘餘腎功能(RRF)的影響.方法 將長治醫學院附屬和濟醫院于2010年5月至2013年7月收治的維持性血液透析患者126例,按照不同血液淨化方式分為高通量血液透析(HFHD)組、低通量血液透析(LFHD)組和血液透析聯閤血液灌流(HD+ HP)組,每組42例.三組依次分彆使用F60、F6透析器、F6透析器聯閤HA130血液灌流器治療6箇月,併採集患者治療前後的血尿標本,計算RRF;同時對比分析治療前後三組患者的三酰甘油、膽固醇、β2微毬蛋白以及血燐濃度水平變化情況.結果 治療6箇月後,三組RRF均顯著低于治療前,差異有統計學意義(分彆t=22.21、21.33、8.32,P均＜0.01);HFHD組和HD+ HF組的RRF下降率均顯著低于LFHD組,差異有統計學意義(分彆t=6.71、5.10,P均＜0.01);而HFHD組RRF與HD+ HF組比較差異未見統計學意義(P＞0.05).同時,治療後HFHD組和HD+ HF組血燐、三酰甘油、β2微毬蛋白及總膽固醇等水平均顯著低于LFHD組,差異有統計學意義(分彆t1=2.24,P＜0.05;t1=3.87,P＜0.01;t2=11.02,P＜0.01;t2=9.22,P＜0.01;t3=2.08,P＜0.05;t3=2.09,P＜0.05;t4=6.97,P＜0.01;t4=8.16,P＜0.01);而HFHD組血燐、三酰甘油、β2微毬蛋白及總膽固醇等水平與HD+ HP組比較差異未見統計學意義(P＞0.05).結論 維持性血液透析患者在不同血液淨化過程中殘餘腎功能均有下降,但HFHD組和HD+ HP組對殘餘腎功能的不良影響相對較小,錶明HFHD組和HD+ HP組可以最大限度地保護殘餘腎功能,值得在臨床中推廣使用.
목적 탐토불동혈액정화방식대유지성혈액투석(MHD)환자잔여신공능(RRF)적영향.방법 장장치의학원부속화제의원우2010년5월지2013년7월수치적유지성혈액투석환자126례,안조불동혈액정화방식분위고통량혈액투석(HFHD)조、저통량혈액투석(LFHD)조화혈액투석연합혈액관류(HD+ HP)조,매조42례.삼조의차분별사용F60、F6투석기、F6투석기연합HA130혈액관류기치료6개월,병채집환자치료전후적혈뇨표본,계산RRF;동시대비분석치료전후삼조환자적삼선감유、담고순、β2미구단백이급혈린농도수평변화정황.결과 치료6개월후,삼조RRF균현저저우치료전,차이유통계학의의(분별t=22.21、21.33、8.32,P균＜0.01);HFHD조화HD+ HF조적RRF하강솔균현저저우LFHD조,차이유통계학의의(분별t=6.71、5.10,P균＜0.01);이HFHD조RRF여HD+ HF조비교차이미견통계학의의(P＞0.05).동시,치료후HFHD조화HD+ HF조혈린、삼선감유、β2미구단백급총담고순등수평균현저저우LFHD조,차이유통계학의의(분별t1=2.24,P＜0.05;t1=3.87,P＜0.01;t2=11.02,P＜0.01;t2=9.22,P＜0.01;t3=2.08,P＜0.05;t3=2.09,P＜0.05;t4=6.97,P＜0.01;t4=8.16,P＜0.01);이HFHD조혈린、삼선감유、β2미구단백급총담고순등수평여HD+ HP조비교차이미견통계학의의(P＞0.05).결론 유지성혈액투석환자재불동혈액정화과정중잔여신공능균유하강,단HFHD조화HD+ HP조대잔여신공능적불량영향상대교소,표명HFHD조화HD+ HP조가이최대한도지보호잔여신공능,치득재림상중추엄사용.
Objective To investigate the effects of different blood purification methods on residual renal function(RRF) in patients with maintenance hemodialysis(MHD).Methods From May 2010 to July 2013,126 patients with maintenance hemodialysis in our hospital were randomly divided into three groups,low flux hemodialysis (LFHD) group,high flux hemodialysis (HFHD) group and hemodialysis combined hemoperfusion (HD + HP) group,with 42 cases in each group.F6 dialyzer,F60 dialyzer,and F6 dialyzer combined with HA130 blood perfusion dialyzer,was used for 6 months in the three groups respectively.Before the treatment and after the treatment for 6 months,the patient' s blood and urine specimens were collected,and the renal function was calculated.Cholesterol,triglycerides,β2-microglobulin and phosphate levels were examined.Results After 6 months of treatment,residual renal function(RRF) was significantly lower than that before the treatment in the three groups,and the differences were statistically significant (t =22.21,21.33,8.32,each P ＜0.01) ; the RRF declining rates in HFHD group and HD + HP group were lower than those in LFHD group,and there were significant differences (t =6.71,5.10,each P ＜0.01) ; but there was no significant difference in the RRF declining rates between HFHD groups and HD + HP groups (P ＞ 0.05).Meanwhile,the serum cholesterol,triglycerides,β2-microglobulin and phosphate levels were significantly lower in HFHD groups and HD +HP groups than those in LFHD groups after the treatment for 6 months(t1 =2.24,P ＜0.05; t1 =3.87,P＜0.01; t2 =11.02,P ＜0.01; t2 =9.22,P＜0.01; t3 =2.08,P ＜0.05; t3 =2.09,P＜0.05; t4 =6.97,P ＜0.01; t4 =8.16,P ＜ 0.01),but there was no significant difference in the serum cholesterol,triglycerides,β2-microglobulin and phosphate levels between HFHD groups and HD + HP groups (P ＞ 0.05).Conclusions RRF declined in hemodialysis patients after dialysis.The decline rates are lower in HFHD and HD + HF groups than that in LFHD group,suggesting that HFHD and HD + HP are better in the protection of the renal function,so it is worthy of clinical popularization.
