高通量透析器复用对同型半胱氨酸、瘦素、甲状旁腺激素清除效果的影响

Effect of High-flux Dialyzer Reuse on the Clearance of HCY、Leptin and PTH

目的:探讨高通量透析器复用对同型半胱氨酸(HCY)、瘦素(Leptin)、甲状旁腺激素(PTH)清除效果的影响。方法:选择20例维持性血液透析患者,在透析器第1、3、5、7次使用时测定透析前后血浆尿素氮(BUN)、同型半胱氨酸(homocysteine,HCY)、瘦素(leptin)和甲状旁腺激素(parathyroid hormone,PTH)水平,并计算KT/V值和物质清除率。结果:透析器进行第1、3、5、7次使用时,血浆HCYl、eptin、PTH水平透析后较透析前下降,且存在显著差异(P<0.05),但3者清除率随复用次数增加呈下降趋势。leptin清除率在透析器第5、7次使用时较第1次使用时均显著降低(P<0.05)。PTH清除率在透析器第7次使用时与第1次使用时也存在明显差(P<0.05)。在透析器复用过程中,KT/V值相互间无显著差异。结论:使用高通量透析能降低血浆HCYl、eptin、PTH水平,减少心血管并发症。复用能保证对小分子的有效清除,但对中分子物质清除呈下降趋势。

Objective：To explore the effection of high-flux dialyzer resuse on the clearance of HCY、Leptin and PTH.Methods： Twenty hemodialysis（HD） patients were enrolled in the study.Pre-and post-dialysis samples were collected to measure BUN、HCY、PTH and leptin clearances after reuses 1,3,5and 7.Results： After dialysis,the levels of HCY、Leptin and PTH fell significantly on reuses 1,3,5,7（P0.05）.But the clearance of Leptin and PTH with reused dialyzer were significantly lower than with first use dialyzers（P0.05）.KT/V value measured by urea kinetic model had no significant difference.Conclusions： High-flux dialyzers provide more than adequate dialysis by lowering plasma HCY、leptin and PTH levels.Small solutes clearances were monitored all through the seven reuse session whereas the clearance of large solutes decreased progressively.