摘要
目的探讨短期高频血液灌流(hemoperfusion,HP)联合血液透析(HD)对患者皮肤瘙痒的治疗效果及安全性。方法规律性血液透析患者15例,每周行3次HP串联HD,疗程为2周(共6次)。观察治疗前后皮肤瘙痒缓解情况并收集实验室资料。结果皮肤瘙痒缓解率初次治疗为66%,疗程结束后为100%。首次治疗后皮肤瘙痒评分(9.5±6.2)较治疗前(24.9±6.9)明显下降,有统计学意义(P<0.01);疗程结束后皮肤瘙痒评分(2.9±2.0)较首次治疗前后均明显下降,有统计学意义(P<0.01)。首次治疗后血甲状旁腺素(PTH)由530.43±409.69pg/ml下降至231.95±236.34pg/ml、血磷(Pi)由1.80±0.46mmol/l下降至0.93±0.28mmol/l,P<0.0l;血25羟维生素D(25(OH)D)由12.48±7.23ng/ml升高至17.05±7.82ng/ml,P<0.0l;疗程结束后与治疗前比较,血PTH有明显下降(P<0.01);血Pi有下降,但无统计学意义(P>0.05);血25(OH)D有所升高,但无统计学意义(P>0.05)。治疗中未发现不良事件和副作用。结论短期高频血液灌流联合血液透析能有效并迅速改善维持性血液透析患者皮肤瘙痒症状,有效提高患者生活质量。
Objective To investigate the effects of short-term high frequency hemoperfusion on skin pru- ritus in regular hemodialysis patients. Methods Fifteen regular hemodialysis patients were treated with he- moperfusion combined with hemodialysis （HP＋HD）, three times a week for 2 weeks. Before and after the treatment, symptoms and scores of skin pruritus were evaluated, and biochemical parameters were collected. Results After the first HP＋HD treatment the remission rate of skin pruritus was 66%, and after the last treat- ment the remission rate was 100%. After the first treatment, skin pruritus score （9.5±6.2） was lower than that before the first treatment （24.9±6.9; P〈0.01）. After last treatment, skin pnaritus score （2.9±2.0） was significant- ly lower than that before and after the first treatment （P〈0.01）. After the first treatment, blood PTH and Pi significantly decreased, PTH decreased from 530.43±409.69 pg/ml to 231.95±236.34 pg/ml, Pi from 1.80± 0.46 mmol/L to 0.93±0.28 mmol/l （P〈0.01）, 25（OH）D increased from 12.48±7.23 ng/ml to 17.05±7.82 ng/ml （P〈0.01）. After the last treatment, blood PTH decreased remarkably compared with that before the first treat- ment （P〈0.01）, but Pi and 25（OH） D changed insignificantly （P〉0.05）. We did not found any adverse effect. Conclusions Short-term high frequency hemoperfusion combined with hemodialysis can effectively and quickly relieve skin pruritus and improve quality of life in regular hemodialysis patients.
出处
《中国血液净化》
2015年第2期97-99,共3页
Chinese Journal of Blood Purification
