组合人工肾、血液透析滤过、血液透析对尿毒症脑病患者β2-微球蛋白的研究

Combination of artificial kidney dialysis, blood filtration hemodialysis patients with uremia encephalopathy β2-microglobulin removal research

目的探讨组合人工肾、血液透析滤过、血液透析对尿毒症脑病(UE)患者β2-微球蛋白(β2-MG)的清除效果。方法选择180例UE患者,随机分为3组,普通血液透析(HD)组、血液滤过(HDF)组和组合人工肾组(HD+HP),每组60例。普通透析组行3次/w的血液透析治疗,血滤组在3次/w透析的中间一次用HDF模式,组合人工肾组在3次/w透析的中间一次用HD+HP模式,总疗程为6w。结果治疗6w后,3组患者的血肌酐、尿素氮、白蛋白、血红蛋白等治疗前后比较,差异无统计学意义(均P>0.05)。HD组透析前血β2-MG与治疗前比较,差异无统计学意义(P>0.05);HDF组血β2-MG从(34.05±4.08)mg·L^(-1)降至(22.49±3.51)mg·L^(-1),与治疗前相比,差异有统计学意义(P<0.05);HD+HP组β2-MG从(34.43±4.21)mg·L^(-1)降至(16.36±3.12)mg·L^(-1),与治疗前相比,差异有统计学意义(P<0.05)。3组对比HD+HP组血β2-MG下降水平明显低于HDF组和HD组(P<0.05)。结论组合人工肾可以更有效地清除UE患者血中的β2-MG。

Objective To investigate the effect of combined artificial kidney, hemodia filtration and hemodialysis on the removal of β2-microglobulin （β2-MG） in uremic encephalopathy （ UE ） . Method A retrospective randomized controlled study was used. Select 180 patients with UE.Randomly divided into three groups： hemodialysis （ HD ） group, hemodialysis filtration （ HDF ） group and the combination of artificial kidney （ HD＋HP ） group, 60 cases/groups, hemodialysis group is 3/w blood dialysis. Hemodialysis filtration group is in the middle of 3/ w dialysis in a HDF mode. The combined artificial kidney group is used in the middle of 3/w dialysis in a HD＋HP mode. The total course of treatment is 6w. Results 6 weeks after treatment.Three group of patients with serum creatinine, blood urea nitrogen, albumin, hemoglobin before and after treatment and compared differences had no statistical significance （ P〉0.05 ） . HD group ： blood dialysis before, β 2-MG there was no statistically significant difference compared with before treatment （ P〉0.05 ） ; HDF group： blood β2-MG from （ 34.05±4.08 ）mg·L^-1, fell to （ 22.49±3.51 ）mg·L^-1.The difference was statistically significant compared with before treatment （ P〈0.05 ） ; HD＋HPgroup： β2-MG from（34.43±4.21） mg·L^-1 fell to （16.36±3.12） mg·L^-1. The difference was statistically significant compared with before treatment （ P〈0.05 ） . 3 contrast HD＋HP group blood β2-MG falling levels significantly lower than the HDF and HD group （ P〈0.05 ） . Conclusion Combination of artificial kidney can effectively remove UE patients blood β2-MG.