摘要
目的观察普通血液透析(HD)、血液透析滤过(HDF)、血液透析加灌流(HP+HD)及可复用高通量血液透析(HFDR)对尿毒症患者血β2-微球蛋白(β2-MG)清除情况。方法选择北京中关村医院长期血液透析患者60例,将患者随机分为HD、HDF、HP+HD、HFDR组,前瞻性对照观察各组患者治疗前后血液及排出液中β2-MG的变化.结果①常规HD治疗后患者血β2-MG明显升高(P<0.01),常规HP+HD治疗后患者血β2-MG升高(P<0.05),HDF及HFDR治疗后血β2-MG明显下降(P<0.01);②HDF、HFDR组排出液β2-MG浓度明显高于HD组(P<0.01);③HFDR组在复用10次治疗后血β2-MG仍然明显下降(P<0.01),应用HFDR组一年以后患者透析前血β2-MG明显下降(P<0.01)。结论普通HD及普通HP+HD不能有效清除患者血β2-MG;HDF及HFDR可有效清除患者血β2-MG。长期应用HFDR可有效持续降低尿毒症维持性血液透析患者血β2-MG水平(P<0.01)。
Objective To observe the effect of hemodialysis （HD）, hemodiafiltration （HDF）, hemodialysis plus hemoperfusion （HP＋HD） and high flux dialysis reuse （HFDR） on clearance of β2-microglobulin （β2MG） in uremic patients. Methods We randomly assigned 60 patients treated with hemodialysis for a long period of time in this hospital into HD, HDF, HP＋HD or HFDR group, and prospectively observed the changes of β2MG in serum and in flow-through dialysate before and after a session. Results Serum β2MG increased significantly after treatment in HD group （P 〈 0.01） and HP＋HD group （P 〈 0.05）. However, serum β2MG decreased significantly after treatment in HDF and HFDR groups （P〈0.01）. β2MG concentration in flow-through dialysate was higher in HDF and HFDR groups than in HD group （P〈0.01）. In HDFR group, serum β2MG remained lower after the reuse for lO times, and the serum β2MG before dialysis session decreased significantly （P 〈0.01） after HFDR for 1 year. Conclusion Effective clearance of β2MG in serum can be seen in patients treated with HDF and HFDR but not in those treated HD and HP＋HD. Long-term application of HFDR can effectively and persistently lower serum β2MG （P 〈 0.01） in maintenance hemodialysis uremic patients.
出处
《中国血液净化》
2009年第3期152-154,共3页
Chinese Journal of Blood Purification
