透析液流量对透析充分性的影响作用研究

Effect of dialyzate flow on the dialysis adequacy

目的分析不同透析液流量对维持性血液透析患者透析充分性的影响作用。方法将48例维持性血液透析患者根据透析液流量的不同分为500ml／min组、600ml／min组、700ml／min组、800ml／min组，每组12例，均治疗6周。每组治疗前和治疗后采血检测白蛋白（Alb）、血红蛋白（Hb）、红细胞压积（Hct）、血尿素氮（BUN）、血清肌酐（SCr）、甲状旁腺激素（iPTH），并计算尿素清除指数（Kt／V）和尿素下降率（URR）。结果500ml／min组和600ml／min组的Kt／V比较差异无统计学意义（P〉0．05），即透析液流量由500ml／min增加至600ml／min不能提高Kt／V，即不能提高透析充分性；500ml／min组、600ml／min组、700ml／min组和800ml／min组Kt／V比较差异有统计学意义，800ml／min组对透析充分性的影响作用更佳。采用自身对照方式比较不同透析液流量对透析充分性的影响，Kt／V随着透析液流量的增加而增加，即透析充分性与透析液流量呈正相关。结论高透析液流量透析能提高患者的Kt／V，对提高透析充分『生的作用显著。

Objective To analyze the dialysis adequacy of the maintenance hemodialysis patients under different dialyzate flow. Methods Forty-eight patients under maintenance hemodialysis were divided into four groups according to dialyzate flow： 500 ml/min group, 600 ml/min group, 700 ml/min group and 800 ml/min group,with 12 patients in each group. Each group was treated 6 weeks. The albumin （Alb）, hemoglobin （Hb）, hematocrit （Hct）, blood urea nitrogen （BUN）, serum creatinine （SCr） and parathyroid hormone （iPTH） levels before and after treatment were examined, Kt/V and urea reduction ratio （URR） were calculated separately. Results There was no significant difference in Kt/V between 500 ml/min group and 600 ml/min group. Kt/V was no increased when the dialyzate flow rate increased from 500 ml/min to 600 ml/min, that was to say they could not improve the dialysis adequacy. There was statistically significant difference in Kt/V among 500 ml/min group, 600 ml/min group, 700 ml/min group and 800 ml/min group, and 800 ml/min group on the dialysis adequacy was better. Different dialyzate flow on the impact of the dialysis adequacy was compared in self-control method. Kt/V increased along with the increase of dialyzate flow, and the dialysis adequacy and dialyzate flow showed positive correlation. Conclusion The high dialyzate flow of dialysis treatment can improve Kt/V and has significant effect in enhancing the dialysis adequacy.