CAJ | 학술논문

目的：探讨血液灌流对于尿毒症患者血清甲状旁腺素（PTH）、β2微球蛋白（β2-MG）水平的影响。方法将本院收治的72例稳定透析的尿毒症患者随机分为联合组和对照组，两组患者均继续给予血液透析治疗，联合组患者在此基础上给予血液灌流治疗，比较两组患者治疗前后 PTH、β2-MG 水平，以及对皮肤瘙痒的疗效。结果治疗前联合组 PTH、β2-MG 分别为（568．5±164．3）ng／dL、（24．3±3．8）mg／L，对照组分别为（582．1±176．4）ng／dL、（25．1±4．2）mg／L，两组间无显著差异（P ＞0．05）；联合组治疗后 PTH、β2-MG 水平为（320．1±89．5）ng／dL、（12．7±3．3） mg／L，较治疗前显著下降（P ＜0．05）；对照组治疗后 PTH、β2-MG 水平为（590．2±180．8）ng／dL、（26．2±5．1）mg／L，与治疗前相比无显著差异（P ＞0．05）；联合组患者皮肤瘙痒治疗的有效率达88．9％，对照组患者的有效率为66．7％，联合组治疗有效率显著高于对照组（P ＜0．05）。结论在常规血液透析的基础上给予尿毒症患者血液灌流治疗能够有效清除患者体内 PTH、β2-MG 等中分子毒素，从而缓解患者的皮肤瘙痒症状。
목적：탐토혈액관류대우뇨독증환자혈청갑상방선소（PTH）、β2미구단백（β2-MG）수평적영향。방법장본원수치적72례은정투석적뇨독증환자수궤분위연합조화대조조，량조환자균계속급여혈액투석치료，연합조환자재차기출상급여혈액관류치료，비교량조환자치료전후 PTH、β2-MG 수평，이급대피부소양적료효。결과치료전연합조 PTH、β2-MG 분별위（568．5±164．3）ng／dL、（24．3±3．8）mg／L，대조조분별위（582．1±176．4）ng／dL、（25．1±4．2）mg／L，량조간무현저차이（P ＞0．05）；연합조치료후 PTH、β2-MG 수평위（320．1±89．5）ng／dL、（12．7±3．3） mg／L，교치료전현저하강（P ＜0．05）；대조조치료후 PTH、β2-MG 수평위（590．2±180．8）ng／dL、（26．2±5．1）mg／L，여치료전상비무현저차이（P ＞0．05）；연합조환자피부소양치료적유효솔체88．9％，대조조환자적유효솔위66．7％，연합조치료유효솔현저고우대조조（P ＜0．05）。결론재상규혈액투석적기출상급여뇨독증환자혈액관류치료능구유효청제환자체내 PTH、β2-MG 등중분자독소，종이완해환자적피부소양증상。
Objective To discuss the blood perfusion in influence of patients with uremia serum parathyroid hor-mone (PTH),beta 2 microglobulin (beta 2-MG)level.Methods 72 cases of patients with uremia given stable dialysis were randomly divided into combined group and control group,patients of two groups were given hemodialysis treat-ment,patients of combined group were given hemoperfusion based on this,PTH、β2-MG levels of patients of two groups before and after treatment and the efficacy of skin pruritus were compared.Results PTH、β2-MG of combined group before treatment were respectively (568.5±164.3)ng/dL、(24.3±3.8)mg/L,those of control group were respectively (582.1±176.4)ng/dL、(25.1±4.2)mg/L,there was no significant difference between two groups (P >0.05);PTH、β2-MG levels of combined group after treatment were respectively(320.1 ± 89.5)ng/dL、(12.7 ± 3.3)mg/L,signifi-cantly decreased than before treatment(P <0.05);PTH、β2-MG levels of control group after treatment were respective-ly (590.2±180.8)ng/dL、(26.2±5.1)mg/L,compared with before treatment,there was no significant difference(P >0.05);The effective rate of patients of combined groups with skin itching treatment was 88.9%,the efficiency of pa-tients of the control group was 66.7%,the effective rate of the treatment group was significantly higher than that of control group (P <0.05).Conclusion Uremia patients were given blood perfusion treatment on the basis of conven-tional hemodialysis,which can effectively remove PTH、β2-MG middle molecule toxins of patients,so as to relive the skin itching of patients.