HDF与HD+HP在MHD患者中的临床应用及对血清甲状旁腺激素清除率的影响

Clinical Use of HDF and HD+HP in Patients of MHD and Its Effect on the Clearance Rate of Serum Parathyroid Hormone

目的:分析血液透析滤过(HDF)与血液透析(HD)+血液灌流(HP)在维持性血液透析(MHD)患者中的临床应用及对血清甲状旁腺激素清除率的影响.方法:选取2018年1-12月于笔者所在医院血液透析中心治疗的MHD患者120例.随机分为三组,各40例,分别为HD组、HDF组、HD+HP组.比较各组治疗前及治疗后6个月血清甲状旁腺激素(PTH)水平、血清甲状旁腺激素清除率,以及皮肤瘙痒、骨关节疼痛、肌无力情况.结果:三组治疗后6个月血清PTH、皮肤瘙痒、骨关节疼痛及肌无力发生率均低于治疗前,且HDF组和HD+HP组血清PTH、皮肤瘙痒、骨关节疼痛及肌无力发生率均低于HD组,差异均有统计学意义(P<0.05).结论:HDF与HD+HP治疗均可明显降低MHD患者血清PTH水平,以及皮肤瘙痒、骨关节疼痛及肌无力等并发症发生率,值得临床推广使用.

Objective:To analyze the clinical use of hemodiafiltration(HDF)and hemodialysis(HD)+hemoperfusion(HP)in patients of maintenance hemodialysis(MHD)and its effect on the clearance rate of serum parathyroid hormone(PTH).Method:A total of 120 patients with MHD who were treated in the hemodialysis center of our hospital from January to December 2018 were selected.Patients were randomly divided into three groups,40 cases in each group,namely HD group,HDF group and HD+HP group.The levels of serum parathyroid hormone before and 6 months after treatment,the clearance rate of serum parathyroid hormone and skin itching,bone and joint pain and muscle weakness were compared.Result:Six months after treatment,the level of serum PTH,the incidence of skin itching,bone and joint pain and muscle weakness in the three groups were lower than those before treatment,and the level of serum PTH,the incidence of skin itching,bone and joint pain and muscle weakness in the HDF group and the HD+HP group were lower than those of the HD group,while the incidence of skin itching,bone and joint pain and muscle weakness in the HD+HP group was lower than that of the HDF group,and the differences were statistically significant(P<0.05).Conclusion:HDF and HD+HP treatment can reduce the level of serum PTH of MHD patients,and reduce the incidence of skin itching,bone and joint pain,muscle weakness,which is worthy of clinical application.