高通量血液透析对长期透析患者血清β_2-MG浓度的影响及其临床意义

Effects of high flux hemodialysis on serum beta 2-microglobulin in long-term hemodialysis patients

目的 探讨高通量血液透析对长期血液透析患者血清 β2 -微球蛋白 (β2 -MG)浓度的影响及临床意义。方法 选择 2 6例长期血液透析患者 (高通量组 14例 ,低通量组 12例 ) ,高通量和低通量透析器均选用聚砜膜 ,表面积均为 1.3m2 ,分别测定两组患者研究开始第一次透析治疗前、后治疗 2周和 6个月时透析前血清 β2 -MG浓度 ,同时观察关节痛程度的变化。结果 高通量透析能有效清除血液透析患者体内的 β2 -MG ,单次高通量透析后患者血清 β2 -MG的下降率达 4 5 .2 % ;高通量组患者血清 β2 -MG浓度在治疗开始、2周及 6个月时分别为 :6 6 .3mg/L、5 1.2mg/L和 4 7.6mg/L ,同时关节痛症状改善 ,而低通量组均无明显变化。结论 高通量透析能够缓解长期血液透析患者的关节痛症状 ,这与高通量透析有效清除并持续降低血液透析患者血清 β2 -MG浓度有关 ,透析膜的通量是影响清除血液透析患者血清 β2 -MG的主要因素。

Objective To investigate the effect of high-flux hemodialysis on the serum beta 2-microglobulin(β_2-MG) in long-term hemodialysis patients.Method Twenty-six long-term hemodialysis patients were selected, including 14 high-flux dialysis Group patients and 12 low-flux dialysis Group patients. The serum β_2-MG levels were measured at the start and at the 2 weeks, 6 months of this study. The symptoms of joint pain were evaluated.Results The serum β_2-MG levels decreased significantly after high-flux dialysis. The percent reduction of β_2-MG levels was 45.2% by the first high-flux dialysis. At start and 2 weeks, 6 months of this study, The serum β_2-MG levels in high-flux dialysis patients were 66.3 mg/L, 51.2 mg/L and 47.6 mg/L, respectively. The symptoms of joint pain significantly improve of in high-flux dialysis patients. During the 6 months of low-flux dialysis,the plasma β_2-MG levels (66.8 mg/L and 65.5 mg/L at the beginning and at the end of low-flux dialysis) and symptoms of joint pain unchanged.Conclusion Our study demonstrated that symptoms of joint pain are improved significantly with high-flux dialysis which is an effective treatment to decrease the serum β_2-MG levels in long-term hemodialysis patients. Membrane flux is the main determinant of β_2-MG levels in long-term hemodialysis.