维持性血液透析患者高通量透析与低通量透析疗效比较

摘要

目的：探讨高通量透析对于维持性血液透析患者疗效的影响。方法通过自身对照的方式，观察接受低通量透析治疗1年以上的42例患者，透析方式更改为高通量透析治疗6月后，对比患者接受高通量透析前及接受高通量透析6月后的临床及实验室指标、患者主观感受的变化，分析高通量透析的疗效。结果高通量透析6月后患者全段甲状旁腺激素、血β2-微球蛋白、C反应蛋白、血压有明显下降（P＜0.05）；血肌酐、尿素氮、血钙、血磷、血浆白蛋白、血红蛋白无明显变化（P＞0.05），但对于血浆白蛋白及血红蛋白水平最低的10位患者进行再次分析，发现这部分患者血浆白蛋白及血红蛋白均有明显提高（P＜0.05）；此外，患者主观感受方面，乏力、食欲、皮肤瘙痒的评分均有明显改善（P＜0.05）。结论高通量透析相对于低通量透析有更好的疗效。%Objectives To observe the effect of high-flux and low-flux hemodialysis in maintenance hemodialysis patients.Methods Through the way of self-control study,we observed 42 patients on maintenance low-flux hemodialysis therapy more than one years,then we changed the dialysis mode to high flux hemodialysis for 6 months without changing any other dialysis prescriptions.Before the change and after the change for 6 months,we compared the laboratory indexesand the patients’subjective feelings,to analysis of the effect ofhigh flux hemodialysis in maintenance hemo-dialysis patients.Results After the change,the parathyroid hormone,serumβ2-microglobulin,C reactive protein,blood pressure decreased significantly(P<0.05); serum creatinine,blood urea nitrogen,serum calcium,serum phosphorus,serum albumin,hemoglobin had no significant changes(P>0.05),but for the plasma albumin and hemoglobin levels in the lowest 10 patients were analysis again,found that these patients’plasma albumin and hemoglobin were significantly improved(P<0.05); in addition,the score of subjective feelings,including fatigue,appetite and skin pruritus scores,were significantly improved(P< 0.05).Conclusions The clinical curative effectof high flux hemodialysiscompared withlow fluxdialysis is better.