高通量血液透析与序贯结合血液透析滤过清除β2微球蛋白的效果比较

Comparison on the efficacies of high flux hemodialysis and sequential combination of hemodiafiltration at different frequency on removing β2-microglobulin

目的比较高通量血液透析(high flux hemodialysis,HFHD)与序贯结合不同频次血液透析滤过(hemodiafiltration,HDF)清除β2微球蛋白(β2-microglobulin,β2-MG)的效果。方法将52例维持性血液透析患者随机分为3组,分别为HFHD组(17例)、联合1组(17例)和联合2组(18例)。HFHD组:每周3次HFHD;联合1组:每2周5次HFHD+2周1次HDF;联合2组:每周2次HFHD+1周1次HDF,每次透析时间均为4 h。免疫比浊法比较三组0.5年及后1年的血清β2-MG的水平。结果三组不同时间段治疗后β微球蛋白均较透析前明显下降(P<0.05),联合2组β2-MG清除率最高,相比HFHD组,三组间β2-MG清除率有统计学差异(P<0.01)。结论 HFHD序贯结合不同频率HDF能提高患者血清β2-MG清除效果,序贯1周1次的较序贯2周1次的HDF效果更好。

Objective To compare the efficacies of hemodialysis and sequential combination hemodiafiltration at different frequency on removing serumβ2-microglobulin(β2-MG).Methods The 52 patients with maintenance hemodialysis were randomly divided into three groups:HFHD group(17 cases),No.1 combined group(17 cases)and No.2 combined group(18 cases);in HFHD group:HFHD 3 times per week;in No.1 combined group:HFHD+HDF 1 time/2w;in No.2 combined group:HFHD 3times/W+HDF once a week.The time of dialysis lasted 4 hours.The levels of serumβ2-MG were compared by immunoturbidimetry between three groups at six months and one year later.Results After above treatment,the levels ofβ-microglobulin in the three groups were significantly lower than those before dialysis(P<0.05),the No.2 combined group was the first in removing rate.Compared with HFHD group,the levels ofβ2-MG removing rate was statistically different(P<0.01).Conclusion HDHD combined with HDF at different frequency can improve the serumβ2-MG removing efficacy,the sequential once a week has better efficacy than the sequential 1 time per two weeks.