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高通量透析器对高磷血症的疗效观察

焦春红,高丽,周洁,张欣,孙涛   

  1. 天津市第二医院
  • 收稿日期:2012-03-12 修回日期:2012-06-29 出版日期:2013-01-15 发布日期:2013-01-15
  • 通讯作者: 焦春红

Curative effect observation of high flux dialyzer treat hyperphosphatemia

  • Received:2012-03-12 Revised:2012-06-29 Published:2013-01-15 Online:2013-01-15
  • Contact: Chun-Hong JIAO

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摘要： 【摘要】 目的对比低通量透析与高通量透析器交替或连续使用后血清Ca、P及甲状旁腺激素(PTH)的变化。方法维持性血液透析(MHD)患者40例,使用130G低通量透析器>3个月,检测其血清尿素氮(BUN)、肌酐(Scr)、尿酸(UA)、血红蛋白(Hb)、白蛋白(Alb)、Ca、P、PTH水平以及皮肤瘙痒发生情况,并据此分为瘙痒组和无瘙痒组比较2组的上述指标。然后40例MHD患者,随机分为2组:HFHD-A组交替使用130G与150U透析器,HFHD-B组连续使用150U高通量透析器。治疗3个月后分别检测上述观察指标的变化及皮肤瘙痒的缓解程度。结果 40例低通量透析患者17例(42.5%)皮肤瘙痒(瘙痒组),瘙痒组血Ca、P水平高于无瘙痒组(P<0.05或P<0.01)。HFHD-A、HFHD-B各组治疗前后血BUN、Scr、UA、Hb、Alb、Ca水平差异无统计学意义(P>0.05)。HFHD-A组治疗后P水平较治疗前降低(P<0.01),HFHD-B组治疗后血P、PTH水平均较治疗前减低(P<0.05或P<0.01)。HFHD-A、HFHD-B2组1个月治疗后皮肤瘙痒发生率差异无统计学意义(P>0.05);3个月后皮肤瘙痒发生率差异有统计学意义(P<0.05)。结论交替或连续使用高通量透析器,能有效地降低血清P及PTH水平,并可缓解MHD患者皮肤瘙痒症。

关键词: 血液透析, 高通量血液透析器, 高磷血症

Abstract: [Abstract ] Objective To contrast the changes of serum calcium, phosphorus and iPTH levels through using of the low flux dialyzer with high flux dialyzer alternately or continually.To approach an effective and feasibility method preventing from hyperphosphataemia and high iPTH level. Methods To choose 40 MHD cases in our hospital who were used the Sureflux-130G low flux dialyzer more than three months. The patients were called the low flux hemodialysis group ( LFHD ), as their own control group. The patients 40 of casses were divided into high flux dialysis A and B two groups ( HFHD-A, HFHD-B ),20 cases in each group. HFHD-A group: to use of 130G and 150U dialyzer alternately; HFHD-B group: to use of 150U dialyzer continually. First, to detection serum BUN, Scr, Hb, Alb, Ca, P, iPTH levels before and after treating with 130G, 150U dialyzer single and contrast their solute reduce rate .Then to measure above mentioned observations after the therapy for 3 months and observe the relieve dugree of Skin pruritus Results After single use of 130G, 150U dialyzer, serum BUN, Scr, UA, Hb, Alb, Ca decrease rate, no significant difference ( P> 0.05 ); serum P, iPTH levels decrease rate showed significant difference ( P < 0.05 ), HFHD group was superior to LFHD group. After the therapy for 3 months, HFHD-A and HFHD-B groups serum P, iPTH levels decreased significantly comparing with LFHD group, showed significant difference ( P < 0.05 ), the serum P removal effect became more remarkable in HFHD-B group（P<0.01）. With HFHD for 1 months, skin itching symptoms that have improved significantly, HFHD-A, HFHD-B two group skin itching relieving degree respectively: 45.5%, 66.7%; effective:72.7%,91.7%; invalid: 27.2%, 0.83%. 3 months after the show: effect: 63.6%, 83.3%; efficiency reached 100%. Skin itching relieving degree of group HFHD-B was significantly higher than that of HFHD-A group. Conclusion It can reduce the serum phosphorus, iPTH levels effectively after use high flux dialyzer alternately or continually. It was important clinical significance to remission secondary hyperparathyroidism, reduce cardio-cerebro-vascular complications decrease mortality in MHD patients.

Key words: Hemodialysis, high flux Hemodialyzer, hyperphosphataemia