不同血液净化方法对尿毒症不安腿综合征的影响效果分析

Analysis the effect of different hemodialysis ways on uremic restless legs syndrome patient

目的:探讨不同血液净化方法用于尿毒症不安腿综合征(RLS)患者的可行性和效果。方法:将符合入选标准的45例患者随机分为血液灌流串联血液透析组(HD+HP)、高通量透析组(HPD)、血液透析组(HD)三组,每组15例。记录首次透析前后及透析2周、4周后血甲状旁腺激素(PTH)、补体(C3、C4)、清蛋白(Alb)、血小板(Plt)等的变化及不安腿综合征临床症状缓解情况,对各组指标进行比较。放射免疫法测定血清PTH水平。结果:(HD+HP)组透析前与首次透析后及透析2周、4周后患者的PTH比较有显著性差异(P<0.05),不安腿综合征缓解率为86.67%(13/15)。HPD组透析前与首次透析后及透析2周、4周后PTH比较有显著性差异(P<0.05和P<0.01),不安腿综合征缓解率为73.33%(11/15)。HD组治疗前后PTH无显著性差异(P>0.05),不安腿综合征缓解率为13.33%(2/15例)。三组在不同阶段补体、血红蛋白含量、清蛋白、血小板计数等比较无显著性差异。结论:血液灌流联合血液透析和高通量透析能有效地清除PTH。能有效缓解不安腿综合征症状。高通量透析治疗无效者改用血液灌流串联血液透析治疗可能有效。而血液透析不能有效地清除PTH,也不能有效缓解不安腿综合征症状。

Objective ：To discuss the feasibility and effect of different hemodialysis ways on uremic restless legs syndrome patient. Meth- ods ：45 patients with uremic restless legs syndrome were divided into hemoperfusion combined with hemodialysis group（ HD ＋ HP） ,high flux dialysis group（HPD） and hemodialysis group（HD） , each group 15 cases. To record the change of parathormone （PTH） , complement（ C3, C4 ） ,albumin（Alb） ,paltelet（Pit） and the remission conditions of restless legs syndrome before and ＇after the first dialysis , and after two weeks and four weeks,to compare the indexs in each group. To mensurate the level of serum parathormone by radioimmunoassay. Results ：The PTH in hemoperfusion combined with hemodialysis group and in high flux dialysis group has remarkable different before dialysis and after the first dialysis, two weeks and four weeks （ P 〈 0. 05 and P 〈 0.01 ）, the remission rate of restless legs syndrome in HD ＋ tiP group was 86.67% （ 13/15 ） and in HPDgroup was 73.33% （ 11/15 ）. There was no different of PTH in HD group before and after dialysis （ P 〉 0.05 ） , the remission rate of restless legs syndrome was 13.33% （ 2/15 ）. There was no remarkable differ- ent on complement, albumin, paltelet in three group and so on.. Conclusion ： Hemoperfusion combined with hemodialysis and high flux dialysis could cleanup PTH and remission conditions of restless legs syndrome effectively.