不同血液净化方式对血管活性肽的影响

目的 观察不同血液净化方式对透析患者血管活性肽的影响及临床疗效.方法 选取45例透析患者,采用自身对照法,随机分为3组：血液透析组（HD组）、血液透析滤过组（HDF组）、血液透析＋血液灌流组（HD＋HP组）.观察3组治疗前、治疗3个月后血内皮素（ET-1）、肾素活性（PRA）、血管紧张素Ⅱ（ATⅡ）水平的变化和临床疗效.结果 HD＋HP组与HDF组治疗后血ET-1和ATⅡ均显著下降（P＜0.05）,而PRA明显升高（P＜0.05）.HD组治疗后PRA、ATⅡ均显著升高（P＜0.01）,ET-1无明显变化（P＞0.05）.HDF组与HD＋HP组治疗后收缩压及舒张压均显著下降（P＜0.01）,而HD组治疗后血压无明显变化（P＞0.05）.结论 HDF与HD＋HP治疗均可改善透析患者难治性高血压,可能与降低血ET-1、ATⅡ水平有关.HD对难治性高血压情况无改善.

Effects of differential blood purification methods on vasoactive peptides

Objective To investigate the influnce and clinical efficacy of differential blood purification methods on vasoactive peptides.Methods 45 dialysis patients were enrolled in this study,and were classified into 3 groups used selfcomparison method：hemodialysis group （HD group）,hemodiafiltration group （HDF group）,and hemodialysis-hemoperfusion group （HD＋HP group）.The plasma levels of ET- 1,PRA,AT Ⅱ were detected before and after the treatment.Results After the treatment,the plasma levels of ET-1 and AT Ⅱ of HD＋HP group and HDF group was both decreased （P〈 0.05）,but the plasma level of PRA was significantly increased （P〈0.05）.After the treatment,the plasma level of PRA and AT H of HD group was both increased （P〈0.01）,but the plasma level of ET-1 had no significant difference （P〉 0.05）.After the treatment,the level of systolic pressure and diastolic pressure of HD ＋HP group and HDF group was both significantly decreased （P〈0.01）,but showed no significant difference in HD group （P〉0.OS）.Conclusion The treatment of hemodiaflhration and emodialysis-hemoperfusion can safely and effectively decrease the plasma levels of plasma eudothelin and AT H ,so they are beneficial to lower blood pressure of dialysis patients with refractory hyper- tension.But the treatment of hemodialysis do not.