CAJ | 학술논문

目的：研究高通量透析对 V 期糖尿病肾病（DN）患者血清甲状旁腺激素（PTH）、β2-微球蛋白（β2- MG）和晚期糖基化终末产物（AGEs）的影响。方法选取2010年1月至2012年3月收治的39例 DN 患者作为研究对象，随机分成两组：其中 HD 组19例患者接受血液透析，HFHD 组10例患者接受高通量血液透析；选取同期体检健康者20例作为对照组。比较各组不同时间（透析治疗前、透析1个月、2个月、3个月、1年、2年和3年后）的血清 PTH、β2- MG 和 AGEs 水平。结果与对照组相比，DN 患者不同时间 PTH、β2-微球蛋白和 AGEs 水平均明显升高（ P ﹤0.05）。两组 DN 患者透析前、透析1个月和2个月的 PTH 和 AGEs 水平无统计学差异（ P ﹥0.05），透析3个月、1年、2年和3年，HFHD 组的 PTH和 AGEs 均明显低于 HD 组，差异具有统计学意义（ P ﹤0.05）。HFHD 组透析后不同时间的β2- MG 水平均明显低于 HD组，差异具有统计学差异（ P ﹤0.05）。结论 HFHD 可以有效清除 V 期 DN 患者血清中的 PTH、β2- MG 和 AGEs，其效果优于常规 HD。
목적：연구고통량투석대 V 기당뇨병신병（DN）환자혈청갑상방선격소（PTH）、β2-미구단백（β2- MG）화만기당기화종말산물（AGEs）적영향。방법선취2010년1월지2012년3월수치적39례 DN 환자작위연구대상，수궤분성량조：기중 HD 조19례환자접수혈액투석，HFHD 조10례환자접수고통량혈액투석；선취동기체검건강자20례작위대조조。비교각조불동시간（투석치료전、투석1개월、2개월、3개월、1년、2년화3년후）적혈청 PTH、β2- MG 화 AGEs 수평。결과여대조조상비，DN 환자불동시간 PTH、β2-미구단백화 AGEs 수평균명현승고（ P ﹤0.05）。량조 DN 환자투석전、투석1개월화2개월적 PTH 화 AGEs 수평무통계학차이（ P ﹥0.05），투석3개월、1년、2년화3년，HFHD 조적 PTH화 AGEs 균명현저우 HD 조，차이구유통계학의의（ P ﹤0.05）。HFHD 조투석후불동시간적β2- MG 수평균명현저우 HD조，차이구유통계학차이（ P ﹤0.05）。결론 HFHD 가이유효청제 V 기 DN 환자혈청중적 PTH、β2- MG 화 AGEs，기효과우우상규 HD。
Objective To study the effect of high flux hemodialysis on parathyroid hormone(PTH),β2 - microglobin(β2 - MG)and advanced glycation end products(AGEs)in patients with stage V diabetic nephropathy(DN). Methods From January 2010 to March 2012,39 patients with DN were chosen as study objects,all patients were divided into 2 groups randomly:19 patients in hemodialysis(HD)group and 20 patients in high flux hemodialysis(HFHD)group. At the same time,20 healthy people were chosen as control group. The levels of PTH,β2 -MG and AGEs of three groups at different time(before treatment,1 month,2 months,3 months,1 year,2 years and 3 years after treatment)were compared. Results Compared with control group,the levels of PTH,β2 - microglobin and AGEs increased significantly in patients with DN( P﹤ 0. 05). Before treatment,1 month,2 months after treatment,the levels of PTH and AGEs had no statistical difference between HD group and HFHD group( P ﹥ 0. 05). 3 months,1 year,2 years and 3 years after treatment,the levels of PTH and AGEs in HFHD group were lower than those in HD group,the differences had statistical significance( P ﹤ 0. 05). After treatment,the level of β2 - MG in HFHD group was lower than that in HD group,the difference had statistical significance( P ﹤ 0. 05). Conclusion The high flux hemodialysis can clear PTH,β2 - MG and AGEs in patients with DN,and its efficacy is better than conventional hemodialysis.