血液透析滤过治疗尿毒症皮肤瘙痒临床研究

摘要

目的：观察血液透析滤过治疗尿毒症患者皮肤瘙痒的临床效果，并探讨其机制。方法：选取2012年12月-2014年12月在笔者所在科室维持血液透析的尿毒症伴有皮肤瘙痒患者36例，随机将其分为血液透析组(HD组)和血液透析联合血液滤过组(HDF组)，各18例。HD组继续维持血液透析，HDF组在血液透析基础上联机应用血液滤过，每周2~3次，每次4 h，疗程为一个月。检测治疗前后甲状旁腺激素(PTH)、血β2微球蛋白(β2-MG)水平，记录皮肤瘙痒症状缓解情况。结果：治疗后，HDF组血中PTH、β2-MG水平均显著低于HD组，而皮肤瘙痒症状缓解率明显高于HD组(P<0.05)。结论：规律血液透析联合血液滤过，能有效缓解尿毒症患者皮肤瘙痒症状。%Objective:To observe the clinical effect of blood dialysis filtration in the treatment of uremic patients with skin itching,and to explore its mechanism.Method:36 maintenance hemodialysis uremia patients with skin itching in our hospital from December 2012 to December 2014,they were randomly divided into the hemodialysis(HD) group and the hemofiltration(HDF) group,18 cases in each group.HD group continued maintenance hemodialysis,the HDF group based on the hemodialysis used blood filtration,2-3 times a week, each time 4 h,the course of treatment for a month.Before and after treatment,the parathyroid hormone(PTH) and serum β2 (β2-MG) levels were detected,the relief of skin itching symptoms was recorded.Result:After treatment,the levels of β2-MG,PTH in the HDF group were lower than those of the HD group,the remission rate of skin pruritus was significantly higher than that of the HD group(P<0.05).Conclusion:Regular hemodialysis combined with blood filtration can effectively alleviate the symptoms of skin itching in uremic patients.