使用超纯透析液对慢性血液透析患者血清瘦素和胰岛素样生长因子-1的影响

The effects of ultrapure dialysate on serum leptin and insulin growth fator-1 in chronic hemodialysis patients

目的观察使用超纯透析液对慢性血液透析患者血清瘦素和胰岛素样生长因子-1的影响。方法长期血液透析患者21例,随机分为超纯透析液和常规透析液组,均用低通量聚砜膜透析器,前瞻性观察两组入组前1周、入组后1周、1月、6月和12月透析前干体重、血白蛋白、血清瘦素和胰岛素样生长因子-1(IGF-1),以及nPCR和Kt/V有无差异。结果至12月观察结束,超纯透析组患者干体重、nPCR、Kt/V、血白蛋白、血清瘦素较常规透析液组的变化均没有差异。在治疗12月后,超纯透析组IGF-1较其基线明显升高(配对t检验P<0.05),但是与对照组的变化相比,没有差异。结论使用超纯透析液应有益于改善慢性血液透析患者的营养状况。

Objective The aim was to observe the effects of ultrapure dialysate （UPD） on nutritional parameters in chronic hemodialysis patients. Methods A controlled, prospective and randomized study was carried out on 21 stable patients dialyzed on low-flux synthetic polysulphone membrane and assigned to either UPD or conventional dialysate （CD）. Blood samples and dialysate samples were collected at pre-dialysis. The variables monitored included Kt/V, normalized protein catabolic rate （nPCR）, dry body weight, serum albumin, serum leptin and IGF-1. They were measured one week before the study, and after one week, one month, six months and twelve months during the dialysis session. Results There were no significant differences in the changes of Kt/V, nPCR, dry body weight, serum albumin and serum leptin between the two groups. At the end of study, there was a significant increase of IGF-1 in UPD group （paired t test, P 〈 0.05）, as compared with their baseline values. However, there was no difference in the changes of IGF-1 between the two groups. Conclusions Use of UPD should be beneficial to the nutritional status in long-term hemodialysis patients.