高通量血液透析的尿素动力学研究

STUDY OF UREA KINETIC MODELING OF HIGHLY PERMEABILITY HEMODIALYSIS

目的 :评价常规透析 (CHD)和高通量透析 (HPD)对 BUN和 β2 - M清除的充分性。方法 :2 1例稳定透析患者随机分为两组 ,A组用普通透析器 (F6 ) ,每周透析 15h;B组用滤过器(F6 0 ) ,每周透析 12 h,分别评价 SRI% BUN、β2 - M下降率、BUN反跳率、KT/ V和 TACurea。 结果 :A组和 B组 SRI% BUN分别为 73.52 %± 6 .89%和 6 9.53%± 5.6 9% ;KT/ V分别为 1.37± 0 .2 3和 1.2 1± 0 .14;TACurea分别为 13.4 6± 4 .15mmol/ L和 14.55± 2 .38mmol/ L;BUN反跳率分别为 2 0 .6 3%± 14.6 5%和 19.6 8%± 12 .6 5% ,以上四对参数 A和 B组均差异不显著。β2 - M下降率分别为 0 .4 55%± 0 .4 4 %和 73.15%± 17.56 % ,差异显著。 结论 :HPD对尿素的清除与 CHD差异不显著 ,对 β2 - M的清除明显优于 CHD。

OBJECTIVE To evaluate the adquacy of β_2 microglobulin(MG)and BUN clearance in conventional hemodialysis and highly permeability hemodialysis(HPD). METHODOLOGY 21 patients were randomized into two groups,Group A dialyzed with dialyzer(F6)for 15 hours per week;and Group B with filter(F60)for 12 hours per week.SRI% BUN,β 2 MG decreasing rate,BUN rebound rate,KT/V and TACurea were assessed respectively. RESULTS In Group A and Group B,SRI%BUN were 73 52%+6 89% and 69 53+5 69% respectively;KT/V were 1 37+0 23 and 1 21+0 14 respectively,TACurea were 13 46+4 15mmol/L and 14 55+2 38 mmol/L respectively;BUN rebound rates were 20 63%+14 65% and 19 68%+12 65% respectively.There were no significant difference of the above parameters between Group A and Group B.While a significant difference was found in the β 2 MG decreasing rate between Group A(0 455%+0 44%)and Group B (73 15%+17 56%). CONCLUSION There was no difference between conventional hemodialysis and HPD in urea clearance.HPD is much more effective in the clearance of β 2 MG than conventional hemodialysis.