高通量血液透析对血清PTH和β_2-MG的影响研究

Study on effects of high flux hemodialysis on serum PTH and β_2-MG

目的探讨高通量血液透析(HFHD)对维持性血液透析(MHD)患者血清甲状旁腺激素(PTH)和β2-微球蛋白(β2-MG)的影响。方法选择58例MHD患者为研究对象,随机将其分为两组,HD组予常规低通量透析,HFHD组予高通量透析HFHD治疗,比较两组患者治疗前及治疗6 w后血清PTH、β2-MG的变化。结果两组治疗开始时,透析前血清PTH、β2-MG比较差异无统计学意义(P>0.05),HFHD组首次透析后血清PTH、β2-MG下降率明显大于HD组(P<0.01);透析治疗6 w后,HFHD组血清PTH、β2-MG均较治疗前明显降低,且均低于HD组水平(P<0.01),而HD组血清β2-MG、PTH较治疗前无明显变化(P>0.05)。结论 HFHD可有效降低血液透析患者血清PTH、β2-MG水平,对防治MHD患者的远期并发症如肾性骨病、透析相关性淀粉样变、心血管并发症等具有重要作用。

Objective To investigate the effects of high flux hemodialysis （HFHD） on serum parathyroid hormone （PTH） and β2-microglobulin （132-MG） in patients receiving maintenance hemodialysis （MHD）. Methods 58 patients receiving MHD were chosen as the research objects and randomly divided into two groups. Group HD was treated by conventional low-flux dialysis, and group HFHD was treated by HFHD. Comparison was made in level changes of serum PTH and β2-MG before and 6 weeks after the treatment between the two groups, Results At the beginning of the treatment, there was no significant difference in serum PTH and β2-MG before the dialysis （P 〉 0.05）. The descent rate of serum PTH and β2-MG in group HFHD was significantly higher than that in group HD （P 〈 0.05）. After the dialysis for 6 weeks, the levels of serum PTH and β2-MG in group HFHD significantly decreased compared with those before the treatment, and all were lower than those in group HD （P 〈 0.01）. The levels of serum PTH and β2-MG in group HD had no significant change before and after the treatment （P 〉 0.05）. Conclusion High-flux hemodialysis can effectively reduce the levels of serum PTH and β2-MG in patients receiving hemodialysis, which plays an important role in the prevention of renal osteodystrophy, dialysis-related amyloidosis, and cardiovascular complications in patients receiving MHD.