摘要
目的探讨高通量血液透析(HFHD)与低通量血液透析(LFHD)对维持性血液透析(MHD)患者血钙、血磷及全段甲状旁腺激素(iPTH)的影响。方法选择天津市中医药研究院附属医院行MHD的患者47例,按患者病情分为LFHD组(24例)和HFHD组(23例)。HFHD组采用费森尤斯Fx600聚砜膜高通量透析器透析;LFHD组采用费森尤斯Fx8膜透析器透析。两组均每周透析3次,每次4 h,连续治疗24周。观察两组治疗前后血钙、血磷及血iPTH水平,并比较血钙、血磷、血iPTH达标率。结果治疗24周后,HFHD组血钙、血磷和血iPTH水平均较治疗前有所下降,但差异无统计学意义〔血钙(mmol/L):2.18±0.16比2.20±0.16,血磷(mmol/L):2.28±0.76比2.39±0.57,血iPTH(ng/L):571.96±447.83比607.00±343.52,均P>0.05〕;而LFHD组除血iPTH略有下降外〔ng/L:419.51±408.22比425.28±379.73〕,血钙、血磷水平反而较治疗前有所升高〔血钙(mmol/L):2.18±0.22比2.18±0.17,血磷(mmol/L):2.11±0.79比2.08±0.49〕,但差异无统计学意义(均P>0.05)。两组治疗前后血钙、血磷、血iPTH达标率比较差异均无统计学意义(均P>0.05),但HFHD组治疗后血磷达标率及血iPTH达标率略高于治疗前〔血磷达标率:26.09%(6/23)比13.04%(3/23),血iPTH达标率:60.87%(14/23)比56.52%(13/23),均P>0.05〕。结论HFHD有可能改善MHD患者骨与矿物质代谢紊乱情况。
Objective To investigate the effects of high flow hemodialysis(HFHD)and low flow hemodialysis(LFHD)on serum calcium,phosphorus and intact parathyroid hormone(iPTH)in maintenance hemodialysis(MHD)patients.Methods Forty-seven hemodialysis patients in Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital were divided into a LFHD group(24 cases)and a HFHD group(23 cases)according to conditions.The HFHD group was hemodialyzed with Fresenius Fx600 polysulfone membrane high flux dialyzer;the LFHD group was hemodialyzed with Fresenius Fx8 membrane dialyzer;both groups received hemodialysis 3 times a week,once 4 hours for consecutive 24 weeks.The levels of serum calcium,phosphorus and iPTH were observed before and after treatment,and the compliance rates of serum calcium,phosphorus and iPTH were compared between the two groups.Results After 24 weeks of treatment,the levels of serum calcium,phosphorus and iPTH in HFHD group were decreased compared with those before treatment,but the differences were not statistically significant[serum calcium(mmol/L):2.18±0.16 vs.2.20±0.16,serum phosphorus(mmol/L):2.28±0.76 vs.2.39±0.57,serum iPTH(ng/L):571.96±447.83 vs.607.00±343.52,all P>0.05].However,in LFHD group,except serum iPTH decreased slightly[ng/L:419.51±408.22 vs.425.28±379.73],the levels of serum calcium and phosphorus were higher than those before treatment[serum calcium(mmol/L):2.18±0.22 vs.2.18±0.17,serum phosphorus(mmol/L):2.11±0.79 vs.2.08±0.49],but the differences were not statistically significant(all P>0.05).There were no significant differences in the reaching standard rates of serum calcium,phosphorus and iPTH between the two groups before and after treatment,but the compliance rates of serum phosphorus[26.09%(6/23)vs.13.04%(3/23)]and iPTH[60.87%(14/23)vs.56.52%(13/23)]in HFHD group after treatment were slightly higher than those before treatment(all P>0.05).Conclusion HFHD may possibly improve the disorder of bone and mineral metabolism in MHD patients.
作者
苗鹏伟
默秀婷
田津生
张勉之
Miao Pengwei;Mo Xiuting;Tian Jinsheng;Zhang Mianzhi(Deparment of Nephrology,Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital,Tianjin 300131,China;Department of Gynecology,First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300380,China)
出处
《中国中西医结合急救杂志》
CAS
CSCD
北大核心
2021年第5期580-583,共4页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
关键词
高通量透析
低通量透析
维持血液透析
骨与矿物质代谢
High flux hemodialysis
Low flux hemodialysis
Maintenance hemodialysis
Bone and mineral metabolism
