CAJ | 학술논문

目的：比较不同血液净化方法的组合对血液透析患者的矿物质和骨代谢的影响。方法将96例终末期肾脏病患者按采用不同的血液净化方式分为3组，A 组为常规血液透析组，B 组为常规血液透析＋血液透析滤过组，C 组为常规血液透析＋血液灌流组。比较3组内及组间治疗6个月前后血钙、血磷、全段甲状旁腺激素（iPTH）、骨密度及其 T 值的变化。结果治疗前后3组间血钙、血磷、iPTH、骨密度、T 值比较差异均无统计学意义（P 均＞0.05）；A 组治疗后的血磷较治疗前升高（P ＜0.05），其余2组无变化；C 组治疗后的 iPTH 较治疗前下降（P ＜0.05）。3组治疗前后的骨密度及 T 值均无明显变化（P 均＞0.05）。结论常规血液透析＋血液透析滤过及常规血液透析＋血液灌流可能有助于稳定血磷水平；常规血液透析＋血液灌流可能有利于降低血 iPTH 水平；短期内透析方法的不同组合对患者的骨密度无明显影响。
목적：비교불동혈액정화방법적조합대혈액투석환자적광물질화골대사적영향。방법장96례종말기신장병환자안채용불동적혈액정화방식분위3조，A 조위상규혈액투석조，B 조위상규혈액투석＋혈액투석려과조，C 조위상규혈액투석＋혈액관류조。비교3조내급조간치료6개월전후혈개、혈린、전단갑상방선격소（iPTH）、골밀도급기 T 치적변화。결과치료전후3조간혈개、혈린、iPTH、골밀도、T 치비교차이균무통계학의의（P 균＞0.05）；A 조치료후적혈린교치료전승고（P ＜0.05），기여2조무변화；C 조치료후적 iPTH 교치료전하강（P ＜0.05）。3조치료전후적골밀도급 T 치균무명현변화（P 균＞0.05）。결론상규혈액투석＋혈액투석려과급상규혈액투석＋혈액관류가능유조우은정혈린수평；상규혈액투석＋혈액관류가능유리우강저혈 iPTH 수평；단기내투석방법적불동조합대환자적골밀도무명현영향。
Objective To compare the effect of different combinations of hemopurification methods on mineral and bone metabolism in hemodialysis patients.Methods A total of 96 patients with end-stage renal disease were divided into three groups according to the different hemopurification treatments that they received:group A received conventional hemodialysis,group B received a combination of conventional hemodialysis and hemodiafiltration,and group C received a combination of conventional hemodialysis and hemoperfusion.Intra-group and intergroup comparisons of changes in serum calcium,phosphorus,intact parathyroid hormone (iPTH),bone density and T value after 6 months of treatment were performed in these 3 groups.Results No statistically significant differences in serum calcium,phosphorus,iPTH,bone density,and T values were iden-tified among the three groups before and after treatment (P >0.05).An elevated serum phosphorus level was observed after treatment in group A (P <0.05),which was not observed in the other two groups.The iPTH level of group C decreased after treatment (P <0.05).No significant changes in bone density and T values were observed after treatment within each of the three groups (P >0.05).Conclusions A combination of conventional hemodialysis and hemodiafiltration or a combination of conventional hemodialysis and hemoperfu-sion can stabilize serum phosphorus levels,while a combination conventional hemodialysis and hemoperfusion facilitates the reduction of the blood iPTH level.Different combinations of hemodialysis methods exerted no sig-nificant short term effects on the bone density of the patients.