血液灌流联合血液透析治疗继发性甲状旁腺功能亢进的疗效观察

Clinical observation of hemoperfusion combined with hemodialysis in the treatment of secondary hyperparathyroidism

目的比较血流灌流(HP)联合血液透析(HD)与常规血液透析(HD)治疗继发性甲状旁腺功能亢进的效果。方法将维持性血液透析伴继发性甲状旁腺功能亢进患者40例随机分成观察组及对照组,各20例,观察组予1周3次血液灌流串联血液透析治疗;对照组予1周3次常规血液透析治疗。比较治疗后两组患者血清甲状旁腺激素(PTH)、血磷(P)水平变化及皮肤瘙痒、骨痛等改善情况。结果治疗4周后两组患者PTH及P均有所下降,但观察组下降程度较对照组更为显著(P<0.05),同时皮肤瘙痒、骨痛等症状明显改善。结论血液灌流联合血液透析可明显降低尿毒症患者PTH及P水平,表明血流灌流串联血液透析治疗维持性血液透析患者继发性甲状旁腺功能亢进有比较满意的疗效。

Objective To compare the effects on the hemoperfusion combined with hemodialysis and conventional hemodialysis in the treatment of secondary hyperparathyroidism.Methods Forty uremia patients complicated with secondary hyperparathyroidism were randomly divided into observation group and control group,each group had 20 cases.Observation group was treated with hemoperfusion combined with hemodialysis in three times a week;control group was treated with hemodialysis in three times a week.The concentration of serum parathyroid hormone（PTH）,phosphorus（P）,pruritus in skin and ostalgia of two groups after treatment were compared.Results The PTH and P of two groups were decreased,which of observation group were decreased obviously than that of control group（P0.05）,meanwhile,pruritus in skin and ostalgia were improved obviously.Conclusion The treatment of hemoperfusion combined with hemodialysis and can decrease the PTH and P of patients with uremia,which has a good effect in the treatment of maintenance hemodialysis patients with secondary hyperparathyroidism.