高通量血液透析和血液透析滤过的临床观察

Clinical Observation of High-flux Hemodialysis and Hemodiafiltration

目的研究高通量血液透析（HPD）和血液透析滤过（HDF）对维持性血液透析患者溶质清除效果及治疗平稳性。方法将26例维持性血液透析患者随机分为2组：HPD组和HDF组，HPD组用金宝AK-95行HPD，HDF组用AK-200US on-line行HDF，两组均采用碳酸氢盐透析液，透析液流量500ml／min，F-60血滤器，时间均为4h/次，3～5次／2周，血流量250～300ml／min；每组随机抽取10份透析前后Bun、Cr、β2-MG、P及3个月后β2-MG，计算溶质清除率；同时观察每组治疗期间及间期症状及体征。结果两组在清除小分子方面疗效相似，在清除中分子上两者明显优于普通血液透析。结论HPD和HDF对中分子及小分子物质的清除率高，治疗过程平稳，是理想的净化方式。

Objective To study the effect of cleaning solute and therapeutic stability about high-flux hemodialysis and hemodiafiltration for patients through maintenance hemodialysis. Methods The 26 patients through maintenance hemodialysis were divided into two groups at random, HPD group and HDF group. The first one was therapied by HPD with AK-95, the other one by HDF with AK-200US on-line, and all the two groups were therapied by dialysis with bicarbonate dialyzate. The flow rate of dialyzate was 500 ml/min,F-60 blood filt,all the time was 4 h once, 3 - 5 orders/2weeks, and BF 250 - 300 ml/min. Every group was taken to 10 portions of BUN, Cr,132-MG, P pro-dialy sis and post-dialysis and β2-MG 3 months later, and calculated the clearance rate of soulte. At the same time the symptom and sings of the two groups in the stage and intermediate stage of therapy. Results The two groups had similar curative effect in the aspect of cleaning micromolecules, and they were outstriped the ordinary, hemodialysis in the aspect of cleaning molecule obviously. Conclusion HPD and HDF is an ideal hematodialysis way, with hypsi-clearance for micronlolecules and molecule, and therapic course is steady.