不同血液净化方式对尿毒症维持性血液透析患者PTH的影响

The Effect of Different Blood Purification Methods on Serum Level of Parathyroid Hormone(PTH) in Uremia Patients with Maintenance Hemodialysis

目的:探讨血液透析(HD)、血液透析滤过(HDF)、血透透析+血液灌流(HD+HP)三种不同血液净化方式对尿毒症维持性血液透析患者血清甲状旁腺激素水平的影响。方法:将75例尿毒症维持性血液透析患者按照随机数字表法分为血液透析(HD)组、血液透析滤过(HDF)组及血液灌流+血液透析(HP+HD)组,每组25例。比较治疗前和治疗6个月后血清甲状旁腺激素(PTH)水平的变化。结果:治疗前与治疗后血清甲状旁腺激素水平变化,HD+HP组与HDF组比较差异均有统计学意义(P<0.05),与HD组比较差异无统计学意义(P>0.05);HD+HP组与HDF组的PTH清除率均优于HD组(P<0.05),HD+HP组与HDF组的PTH清除率比较,差异无统计学意义(P>0.05)。结论:不同的血液净化方式降低PTH有差异,其中HD+HP组、HDF组较HD组相比,能更好的清除PTH,提高临床治疗效果。

Objective： To investigate the effect of hemodialysis（HD）, hemodiafiltration（HDF） and hemodialysis plus hemoperfusion （HD＋HP） on serum level of parathyroid hormone（PTH） in uremia patients with maintenance hemodialysis.Method： 75 uremia patients with maintenance hemodialysis were randomly divided into the hemodialysis group the hemodiafiltration group and the hemodialysis plus hemoperfusion group. 25 cases in each group Serum level of parathyroid hormone at before and after treatment were compared.Result： Compared before and after treatment, the PTH of the HD＋HP group and the HDF group showed significant decrease of serum parathyroid hormone（P〈0.05）.However, patients in the HD group showed no difference of serum parathyroid hormone（P〉0.05）.Clearance rates of PTH in the HDF group and the HD＋HP group were better than that in HD group（P〈0.05）.There was no significant difference in PTH clearance rate between the HDF group and the HD＋HP group（P〉0.05）. Conclusion： There are differences between the different means of blood purification reduce PTH, the HDF group and HD＋HP group further decrease serum parathyroid hormone level compared with the HD group, this can improve the clinical efiqcacv.