高通量血液透析对维持性血液透析患者β_2-微球蛋白和甲状旁腺激素及左心功能的影响

Effect of High- flux Hemodialysis on β_2- microglobulin,Parathyroid Hormone and Cardiac Function in Patients with Maintenance Hemodialysis

目的观察高通量血液透析(HFHD)对维持性血液透析患者β2-微球蛋白(β2-MG)、甲状旁腺激素(PTH)及左心功能的影响。方法选取2010年1月—2013年4月在我院血液净化中心行维持性血液透析患者70例,将其随机分为HFHD组38例和常规血液透析(HD)组32例,分别于治疗前及治疗6个月后检测两组患者生化指标(尿素氮、肌酐、钙、磷、PTH、β2-MG);并测量左室舒张末内径(LVEDd)、左心室射血分数(LVEF)、左房室瓣前向血流E峰与A峰比值(E/A)。结果治疗前后两组患者尿素氮、肌酐、钙比较,差异无统计学意义(P>0.05);治疗后HFHD组血磷、PTH、β2-MG均低于HD组(P<0.05)。治疗后两组LVEDd比较,差异无统计学意义(P>0.05);HFHD组LVEF、E/A高于HD组(P<<0.05)。结论 HFHD对维持性血液透析患者的β2-MG、PTH有明显清除作用,并可改善左心功能,优于HD。

Objective To observe the effect of high - flux hemodialysis （ HFHD ） on serum β2 - microglobulin （1332 -MG）, parathyroid hormone （PTH） and cardiac function in patients with maintenance hemodialysis. Methods 70 patients with maintenance hemodialysis admitted to our hospital from January 2010 to April 2013 were randomly divided into hemodialysis （HD） group （32 cases） and HFHD group （38 cases） .The levels of serum β2-MG, urea nitrogen, Cr, Ca, P, LVEDd, LVEF and E/A between two groups were compared before and 6 months after treatment. Results There was no significantly differences in urea nitrogen, Cr, Ca between two groups before and after treatment （P 〉0. 05） . After treatment, the serum levels of P, PTH, β2 - MG in HFHD group were lower that those of HD group, LVEF, E/A higher （ P 〈 0. 05 ） . There was no significantly difference in LVEDd between two groups after treatment （P 〉 0. 05）. Conclusion HFHD in treating for maintenance hemodialysis can reduce the level of serum β2 - MG and PTH, improve cardiac function, being better than HD.