血液灌流联合血液透析对血地高辛清除率的影响

The clearance rate of serum digoxin in mailtanance hemodialysis patients of different dialysis modalities

目的观察血液灌流联合血液透析（HP＋HD）、血液透析（HD）对维持性血液透析（MHD）患者血地高辛清除率的影响。方法选择30例MHD患者每周行HP＋HD治疗1次、HD治疗2次，每次治疗4h。采用自身前后对照研究，每例患者分别观察HP＋HD治疗1次、HD治疗1次，总计60例次，分为HD＋HP组30例次和HD组30例次。观察2组透析前后血地高辛浓度、尿素氮（BUN），比较2组治疗前后血地高辛浓度、地高辛清除率、尿素下降率（URR）和单室模型尿素清除指数（spKt／V）。结果2组治疗前血地高辛浓度、URR和spKt／V比较无统计学差异（P〉O．05）。2组治疗后血地高辛浓度均显著低于治疗前（P〈0．01），但HD＋HP组血地高辛清除率明显高于HD组（P〈0．01）。结论两种透析方式对血液中地高辛均有清除作用，HP＋HD治疗对地高辛清除率较HD治疗效果高。

Objective To observe the effect on clearance of serum digoxin in maintenance henxxtialysis patients（MHD） with different modes of blood purification, hemoperfusion（HP） combined with hemodialysis （HD） and conventional hemodialysis（HD）. Methods 30 MHD patients with Oral digoxin maintenance dose （0. 125 nag qod） were selected to accepted the both two kinds of dialysis treatment, HP ＋ HD treatment once a week, HD treatment twice a week, each treatment last 4 hours. Adopting self-control study,each patient was observed before and after blood purification （HP ＋ HD, HI） treatment each respectively）. 60 cases were divided into HD＋ HP group and HD group, 30 eases in each group. The serum concentration of digoxin and urea nitrogen were recorded before and after the treatment The digoxin clearance rate, urea reduction rate （URR） and single-Fool Kt/V （spKt/V） were compared in the two different treatments, Results The serum concentration of digoxin after the treatment of HP ＋ HD and HD were significantly lower than that before treatment （P〈0. 01）. But the digoxin clearance rate of HD＋ HP group was much higher than in the HD group （P〈0. 01 ）. The serum concentration of digoxin as well as the URR and spKt/V of the two groups be- fore the treatment had no difference （P〉0. 05）. Conclusions Both modes of blood purification, HP ＋ HD and HD, had the effect on eliminating the digoxin in the blood. But the effect of HP ＋ HD was much more better than HD.