高通量血液透析联合血液灌流对血清PTH和ALB的影响

Effects of high-flux hemodialysis combined with hemoperfusion on serum PTH and ALB in maintenance hemodialysis patients

目的探讨高通量血液透析(HFHD)联合血液灌流(HP)对血清甲状旁腺素(PTH)和血清白蛋白(ALB)的影响。方法选取30例维持性低通量血液透析合并继发性甲状旁腺功能亢进的患者,随机分为LFHD和HFHD+HP两组,每组各15例,LFHD组予常规低通量血液透析,每周三次;HFHD+HP组予每两周5次常规低通量透析,每两周一次HFHD+HP治疗,于0个月、12个月分别检测两组的血清Ca2+、P3+、i PTH、ALB的浓度。结果治疗12个月后,两组比较发现:HFHD+HP组的i PTH明显下降,ALB明显升高(P<0.05),LFHD组的i PTH、ALB无明显变化(P>0.05);两组治疗后比较,HFHD+HP组的P3+,hs-CRP明显降低,差异有统计学意义(P<0.05),Ca2+差异无统计学意义。结论 HFHD联合HP治疗能有效清除MHD患者的PTH,长期应用可以升高血清ALB,改善营养状态。

Objective To investigate the effect of high-flux hemodialysis（HFHD） combined with hemoperfusion （HP） on parathyroid hormone （PTH） and serum albumin （ALB）. Methods A to 30 patients treated with maintenance low-flux hemodialysis with secondary hyperparathyroidism were included in the study. All patients were randomly divided into two groups： low flux hemodialysis group （LFHD, n=15） and high flux hemodialysis combined with hemoperfusion group （HFHD＋HP, n=15）. For LFHD group, patients accepted LFHD treatment 3 times per week. For HFHD＋HP group, pa- tients were treated with HFHD＋HP once every two weeks, additionally, patients in HFHD＋HP group underwent LFHD treatment 5 times per two weeks. Serum calcium, phosphorus, iPTH and albumin （ALB） were tested between the two groups at zero and twelfth month after treatment. Results The level of iPTH decreased and the level of ALB increased significantly in HDHP＋HP group compared to the LFHD group（P〈0.05） after 12 months of treatment. The level of iPTH and ALB had no significant differences （P〉0.05）. After treatment, the level of p3＋, hs-CRP of HFHD＋HP group de- creased, there was significant difference （P〈0.05）. There was no significant difference of serum calcium between two groups （P〉0.05）. Conclusion HDHP combined with HP therapy may effectively remove PTH and increase ALB in main- tenance hemodialysis patients.