相关血清学指标水平在肾衰竭患者不同透析方法治疗中的变化

Change of serological indicators in different hemodialysis methods

目的探讨血清BUN、Cr、P、PTH在肾衰竭患者采用不同血液透析方法治疗前后水平的变化。方法选择200例慢性肾衰竭患者,随机分为常规血液透析(RHD)组、血液透析滤过(HDF)组,两组各100例。在单次透析前后及连续透析1个月后采集血标本用化学法测定血清BUN、Cr、P水平,放射免疫法测定血清PTH水平。结果单次透析后,HDF组血清BUN、Cr、P、PTH水平均显著下降(P<0.01),但均未达到正常水平。RHD组虽血清BUN、Cr水平显著下降(P<0.01),但血清P、PTH水平无显著下降(P>0.05);BUN、Cr水平也未达到正常水平。HDF组和RHD组BUN、Cr清除程度比较差异无统计学意义(P>0.05);HDF组和RHD组P、PTH清除程度比较差异有统计学意义(P<0.01)。连续透析1个月后,HDF组患者血清P、PTH水平与透析前比较差异有统计学意义(P<0.01),RHD组患者血清P、PTH水平与透析前比较差异无统计学意义(P>0.05)。结论 HDF可有效清除外周血BUN、Cr、P、PTH,长期应用可显著提高患者生活质量及存活率,RHD不能有效清除P、PTH。

Objective To investigate the change of serum BUN,Cr,P,PTH in patients with chronic renal failure underwent different hemodialysis methods.Methods 200 patients with chronic renal failure were divtded into conventional hemodialysis（RHD） group and hemodialysis filtration（HDF） group.The levels of serum BUN,Cr,P were deiected by chemical method,while the level of serum PTH was detected radioimmunoassay before,after one-month single hemodialysis and after continuous hemodialysis.Results After single hemodialysis,the level of serum BUN,Cr,P,PTH in HDF group were significantly decreased（P0.01）.And in RHD group the levels of serum P and PTH did not decrease significantly（P0.05）.Comparing with HDF groups the RHD group did not have significant difference in the level of BUN and clearance,but had significant difference in the levels of P and PTH.Comparing single hemodialysis and one-month continuous hemodialysis,the levels of serum P and PTH were significant lower in HDF group（P0.01）,but not in RHD group（P0.05）.Conclusion HDF could be effective to clear serum BUN,Cr,P and PTH.The life quality and survival rate of patients could be significantly improved by long-term hemofiltration.RHD might be not effective to clear serum P and PTH.