血液滤过治疗尿毒症皮肤瘙痒临床研究

Clinical Research on Hemofiltration for Treatment of Skin Itch in Uremia Patients

目的探讨血液滤过治疗尿毒症患者皮肤瘙痒临床疗效及其机制。方法将尿毒症维持血液透析伴有皮肤瘙痒的32例病人，随机分为两组。对照组（16例）继续维持血液透析，治疗组（16例）在血液透析基础上联机应用血液滤过，每周2—3次，每次4h，疗程1个月，记录皮肤瘙痒消失例数，治疗前后分别查血132微球蛋白（β2-MG）、甲状旁腺激素（PTH）。结果治疗后治疗组13例皮肤癌痒消失；对照组无1例皮肤瘙痒消失；血中β2-MG，PTH治疗组下降明显，与对照组比较，P〈0．05。结论血液滤过能改善尿毒症皮肤瘙痒症状，亦可降低血中β2-MG，PTH浓度。

Objective To investigate the clinical ibflucncc of hemofiltration on uremia patients＇ skin itch. Methods Analysis was conducted on the urcima patients treated with continual hcmodialysis covering a period from March 2004 to December 2006 in my hospital, among whom the 32 patients suffering from skirl itch were further divided into two groups on randomization principle. In thcrapeutic group （ n =16 ; 9 males, 7 females） , the patients＇ average age was 56.8 ±21.3 （ mostly 20 - 78 ） years, and in control group （ rt = 16 ; 10 malcs, 6 females） the counterpart was 57.9±20.8 （ mostly 21 - 79）. The patients in the control group were treated continually with hcmodialysis, and those in the therapeutic group were treated additionally with hemofiltration besides hemodialysis. The hemofiltration lasting for one month as a course was performed 2 - 3 times a week （4 horn＇s pcr timc）. Bcforc and after the treatment, the serum β2-microglobin （β2-MG） and parathyroid hormone （PTH） were monitored respectively. Results After the treatment, the time, within which the skin itch symptom disappeared, was significantly shognificantly shorter, and the levels of β1- MG and PTH in serum were significantly lower in the therapeutic group than in the control group. Conclusion Hcmofiltration can not only improve the skin itch symptom of uremia patients, but decrease the levels of β2-MG and PTH in serum as well.