不同透析方式对维持性血液透析患者血清甲状旁腺素、晚期糖基化终末产物及尿素氮的影响

摘要

Objective To observe the effect of hemodialysis ( HD), high - flux hemodialysis ( HFHD) and blood hemodiafiltration (HDF) dialysis on serum parathyroid hormone (PTH), advanced glycation terminal products (AGEs) and urea nitrogen (BUN) of patients with chronic renal failure (CRF). Methods 90 patients with CRF were randomly divided into three groups. Dialysis times of three groups are 4. 0 to 4. 5 h, 2 to 3 times a week. HD group were treated with low - flux polysulfone membrane dialyzer F6, the blood flow of 250 to 300 mL/min. HFHD and the HDF groups were treated with high - flux polysulfone membrane F60 filtration, blood flow 200 to a 250 ml/ min, the HDF group adopted post - replacement, the replacement fluid in a total of 19 - 32 - L. PTH, ACEs and BUN levels were measured in three groups before and after a single dialysis, and the rate of decline was calculated. Results PTH and AGEs after dialysis in HDF and HFHD groups were decreased as compared with those before dialysis in HDF and HFHD groups and after dialysis in HD group (P<0.05). There was no difference between HDF group and HFHD group after dialysis on PTH and AGEs (P > 0.05 ). There was significant difference between before and after treatment in three groups on BUN (P < 0.05). There was no difference between three groups after dialysis on BUN (P > 0.05). The rate of decline for PTH and AGEs in HDF group and HFHD group was higher than that in HD group (P < 0.05). There was no difference between HDF group and HFHD group after dialysis on the rate of decline for PTH and AGEs (P>0.05). Conclusion HFHD, HDF is better able to remove toxins from the body in uremic patients.%目的 观察血液透析(HD)、高通量血液透析(HFHD)、血液透析滤过(HDF)3种透析方式对慢性肾衰竭(CRF)患者血清甲状旁腺素(PTH)、晚期糖基化终末产物(AGEs)及尿素氮(BUN)的影响.方法 将90例CRF患者随机分成3组,各30例.3组透析时间均为每周2～3次,每次4.0～4.5 h.HD组采用低通量聚砜膜透析器F6,血流量250 ～ 300 mL/min,HFHD、HDF组均采用高通量聚砜膜F60滤过器,血流量200～250 mL/min,HDF组采用后置换,置换液总量为19 ～ 32 L.分别测定3组单次透析前后PTH、AGEs及BUN水平,并计算下降率.结果 HDF组、HFHD组透析后PTH、AGEs与本组透析前和HD组透析后比较差异均有统计学意义(P＜0.05),HDF组、HFHD组透析后PTH、AGEs水平组间比较差异无统计学意义(P＞0.05).3组透析后BUN与本组透析前比较差异均有统计学意义(P＜0.05),组间比较差异均无统计学意义(P＞0.05).HDF组、HFHD组PTH、AGEs下降率明显高于HD组(P＜0.05),HDF组、HFHD组PTH、AGEs下降率组间比较差异无统计学意义(P＞0.05).3组BUN下降率比较差异无统计学意义(P＞0.05).结论 HFHD、HDF能更好的清除尿毒症患者体内毒素.