血液透析串联血液灌流治疗肾性骨病30例临床分析

Clinical analysis of the 30 cases with hemoperfusion-hemodialysis series curative effect for renal osteodystrophy

目的研究血液透析串联血液灌流对维持性血液透析患者肾性骨病相关因素的影响及可能的作用机制。方法将血液透析患者随机分为治疗组(血液透析串联血液灌流,n=30例)、对照组(单纯血液透析,n=26例)。观察两组治疗8周前后皮肤瘙痒等症状的改善和起效时间,及血钙、血磷、iPTH值变化。结果治疗组皮肤瘙痒等症状改善优于对照组,两组比较差异有统计学意义(P<0.001)。治疗组血磷、甲状旁腺激素明显下降,差异有统计学意义(P<0.001);对照组治疗前后各项指标比较,差异无统计学意义。两组比较差异有统计学意义(P<0.001)。结论血液透析串联血液灌流治疗能显著降低患者血iPTH和血磷水平,改善肾性骨病临床症状。

Objective To investigate hemoperfusion-hemodialysis series influence on renal osteodystrophy and underlying mechanism.Methods Maintenance hemodialysis patients were randomly divided into the treatment group（HP-HD series n=30）and control group（pure HD n=26）.The time of skin pruritus relief as well as mitigation time and the level of Ca,Phos,iPTH in serum were measured in two groups respectively after 8 weeks.Results Skin pruritus relief was more remarkable in treatment group than in control group with statistical difference（P〈0.001）.The level of Phos and iPTH statistically declined in treatment group（P〈0.001）,and there was no statistical difference in control group（P〈0.001）.There was statistical difference between two groups.Conclusions The level of iPTH and Phos are significantly decreased by HP-HD,along with amelioration of osteodystrophy manifestation.