高流量血液透析对尿毒症维持性血液透析患者血清溶质的清除效果

Effect of high flow hemodialysis on serum solute in uremic patients with maintenance hemodialysis

目的探讨高流量血液透析对尿毒症维持性血液透析患者血清溶质的清除效果。方法选取2017年2月至2017年12月于宿州市立医院就诊的尿毒症维持性血液透析患者88例为研究对象,采用随机数表法将其分为观察组(44例)和对照组(44例),观察组患者采用高流量血液透析,对照组患者采用低流量血液透析,对比两组患者血清肌酐(serum creatinine,Scr)、血尿素氮(blood urea nitrogen,BUN)、β_2微球蛋白(β_2-microglobulin,β2M)、丙二醛(malonaldehyde,MDA)及全段甲状旁腺激素(intact parathyroid hormone,iPTH)、血清钙和磷水平。结果透析5次时,两组患者BUN、Scr、β_2M、MDA水平均显著低于本组透析前(P_均<0.05);观察组患者透析5次时Scr、β_2M、MDA水平均显著低于同期对照组(P_均<0.05)。透析12周,两组患者iPTH、血清磷水平均显著低于本组透析前(P_均<0.05),血清钙水平均显著高于本组透析前(P_均<0.05);观察组患者透析12周时iPTH、血清磷水平均显著低于同期对照组(P_均<0.05),血清钙水平显著高于同期对照组(P <0.05)。结论高流量血液透析能够降低尿毒症维持性血液透析患者iPTH、BUN、Scr、β_2M、MDA、血清磷水平,升高血清钙水平。

Objective To investigate the clearance effect of high flow hemodialysis on serum solute in uremia patients with maintenance hemodialysis.Method 88 uremic patients with maintenance hemodialysis from February 2017 to December 2017 were randomly divided into observation group(n=44)and control group(n=44).Observation group patients were treated with high flow hemodialysis and control group patients were treated with low flow hemodialysis.The levels of blood urea nitrogen(BUN),serum creatinine(Scr),β2-microglobulin(β2M),malonaldehyde(MDA)and intact parathyroid hormone(iPTH),serum calcium and phosphorus of the two groups were compared.Result At 5 dialysis sessions,the levels of BUN,Scr,β2M and MDA in both groups were significantly lower than those before dialysis(Pall<0.05);the levels of Scr,β2M and MDA in observation group were significantly lower than those in control group(Pall<0.05).After 12 weeks of dialysis,the levels of iPTH and serum phosphorus in both groups were significantly lower than those before dialysis(Pall<0.05),and serum calcium levels were significantly higher than those before dialysis(Pall<0.05).The levels of serum phosphorus and iPTH in observation group were significantly lower than those in control group after 12 weeks of hemodialysis(Pall<0.05),and the level of serum calcium in observation group was significantly higher than that in control group after 12 weeks of hemodialysis(P<0.05).Conclusion High flow hemodialysis can reduce the levels of BUN,Scr,iPTH,β2M,MDA and phosphorus in uremic patients with maintenance hemodialysis,and increase the level of serum calcium.