树脂吸附对透析相关性淀粉样变治疗效果及生活质量的探讨

The study of the resin adsorption on patients of dialysis-related amyloidosis in clinical efficacy and quality of life

目的探讨树脂吸附对维持性血液透析（MHD）患者透析相关性淀粉样变（DRA）的防治作用及生活质量的影响。方法将40例合并DRA患者随机分为树脂吸附＋血液透析组（HP＋HD）和常规血液透析组（HD）。HP＋HD组在每周3次常规血液透析的同时，接受每2周1次的HP治疗；HD组行每周3次常规血液透析。分别于治疗前、治疗3个月时应用SF-36量表进行生活质量评分，检测血清B2—M、Hs—CRP的变化；并用磁共振（MRI）检查患者双侧肩关节，检测肩关节MRI阳性征象，观察临床症状改变情况。结果HP＋HD组治疗后患者生活质量评分怀（86．39±26．46）升到（104．30±20．69）（P〈0．05）;β2-M从（13．48±4．69）mg／ml降至（5．91±1．73）mg／ml（P〈O．01）;Hs—CRP从（15．86±5．12）pg／ml降至（8．86±3．36）pg／ml（P〈0．01），MRI影像学征像和临床症状治疗后均明显改善（p〈0．05），治疗前后比较差异均有显著性。结论DRA患者在常规HD治疗的同时接受HP治疗能有效的改善或缓解其DRA，并提高其生活质里。

Objective To study the Resin Adsorption of Maintenance Hemodialysis （MHD） patients with Dialysis-Related Ainyloidosis （DRA） regarding clinical efficacy and their quality of life. Methoda 40 patients with DRA were randomly divided into two groups - a Resin Adsorption plus Hemodialysis treatment group （HP ＋ HD） and a Hemodialysis treatment group （HD）. The HP＋HD group was given Hemodialysis treatment 3 times every week plus 1 HP treatment every 2 weeks. The HD group was given Hemodialysis treatment 3 times every week. SF-36 Quality of Life Scale scores and the changes of serum 132-M, Hs-CRP were used to measure the differences of before and after 3 months of treatments. In addition, Magnetic Resonance （MRI） was used to examine patients＇ bilateral shoulder joint to check for the indications of abnormality. Clinical symptom changes were also observed. Results After the treatment, for tip ＋ HD group, the quality of life score was increased from （g6.39 ± 26.46） to （104.30 ± 20.69） （P〈O. 05）; β2-M was decreased from （13.48 ± 4.69） mg / ml to （5.91± 1.73） mg / ml（P〈0.01）; Hs - CRP was decreased from （15.S6 ± 5.12） pg / ml to （8.86 ±3.36） pg / ml（P〈0.01）. MRI image and clinical symptoms were improved after treatment （P〈0.05）. There was a significant difference between before and after treatment. Conclusions For DRA patients, in addition to the conventional HD treatment concurrent HP treatment not only effectively improve or alleviate the DRA hut also improve their quality of life.