组合型人工肾对血液透析患者甲状旁腺素影响的观察

Observation on effect of combined artificial kidney on parathyroid hormone in hemodialysis patients

目的探讨组合型人工肾[血液灌流(HP)联合血液透析(HD)]在降低HD患者血清甲状旁腺素(PTH)水平中的作用。方法 34例接受维持性血液透析的尿毒症患者,按照数字表法分为研究组和对照组,每组17例。研究组采用HP+HD治疗,而对照组则采用单纯HD治疗。比较两组患者治疗前后血钙、血磷、PTH的变化情况。结果治疗前两组血钙、血磷、PTH水平比较差异均无统计学意义(P>0.05)。治疗后两组血钙水平与治疗前比较差异均无统计学意义(P>0.05),且组间比较差异无统计学意义(P>0.05);治疗后两组血磷、PTH水平与治疗前比较差异均具有统计学意义(P<0.05)。治疗后研究组血磷(1.87±0.24)mmol/L、PTH(285.01±27.88)pg/ml低于对照组(2.47±0.20)mmol/L、(310.52±24.36)pg/ml,差异均具有统计学意义(P<0.05)。结论组合型人工肾(HP联合HD)可以有效降低血液透析患者血清PTH水平。

Objective To explore effect of combined artificial kidney [ hemoperfusion （HP） combined with hemodialysis （HD） ] in decreasing parathyroid hormone （PTH） of HD patients. Methods A total of 34 uremia patients with maintenance hemodialysis were divided by random number method into research group and control group, with 17 cases in each group. The research group received HP＋HD treatment, and the control group received only HD treatment. Comparison were made on blood calcium, blood phosphorus and PTH before and after treatment in two groups. Results Blood calcium, blood phosphorus and PTH before treatment had no statistically significant difference in two groups （P〉0.05）. Blood calcium in both groups had no statistically significant difference after treatment compared with before treatment （P〉0.05）, and there was no statistically significant difference in two groups （P〉0.05）. Both groups had statistically significant difference in blood phosphorus and PTH after treatment compared with before treatment （P〈0.05）. The research group had blood phosphorus as （1.87 ± 0.24）mmol/L and PTH as （285.01 ± 27.88）pg/ml after treatment, which were lower than （2.47 ± 0.20）mmol/L and （310.52 ± 24.36）pg/ml in the control group. Their difference had statistical significance （P〈0.05）. Conclusion Combined artificial kidney （HP combined with HD） can effectively reduce PTH level in hematodialysis patients.