高通量血液透析与血液透析滤过对终末期肾功能衰竭患者认知功能的影响

The Affection on Cognitive Function in End-stage Renal Failure Patients Needed Maintenance Dialysis by High-flux Hemodialysis and Hemodiafiltration

目的:观察高通量血液透析、血液透析滤过对维持性透析终末期肾功能衰竭患者认知功能的影响。方法:82例维持性透析终末期肾功能衰竭患者随机分为两组,A组41例采用高通量血液透析,B组41例采用血液透析滤过,观察透析前后血肌酐(Scr)、β2-微球蛋白(β2-MG)水平及患者认知功能的变化。结果:两组透析治疗后Scr和β2-MG水平均明显下降(P<0.05)。A组β2-MG水平明显低于B组(P<0.05),两组Scr水平比较,差异无统计学意义(P>0.05)。两组治疗后PL和Amp明显较治疗前明显改善,差异有统计学意义(P<0.05)。A组PL和Amp改善情况明显优于B组,差异有统计学意义(P<0.05)。结论:高通量血液透析、血液透析滤过作为维持性透析终末期肾功能衰竭患者常用的两种透析方式,均能够有效清除体内血Scr、β2-MG,而高通量血液透析在清除β2-MG,改善患者认知功能方面明显优于血液透析滤过。

Objective：To observe the affection of cognitive function in end-stage renal failure patients needed maintenance dialysis by high-flux hemodialysis and hemodiafiltration.Methods：82 cases of end-stage renal failure patients needed maintenance dialysis were randomly separated into two groups,which A group was used high-flux hemodialysis and B group was used hemodiafiltration.The serum β2-MG,Scr and cognitive function before and after treatment were observed.Results：The levels of serum Scr and β2-MG in both two groups were significantly decreased after treatment.Moreover,the levels of β2-MG in A group were significantly lower than those in B group（P0.05）.The PL and Amp in both two groups were significantly improved after treatment.Moreover,the PL and Amp in A group were significantly better than those in B group（P〈0.05）.Conclusion：Both high-flux hemodialysis and hemodiafiltration are effective methods for end-stage renal failure patients needed maintenance dialysis,and can clearance serum Scr and β2-MG,of which high-flux hemodialysis is more effective in β2-MG clearance and cognitive function improvement.