维持性血液透析患者高甲状旁腺素血症的临床治疗观察

目的 探讨两种血液净化方法对维持性血液透析患者高甲状旁腺素血症（PTH）的疗效.方法 将101例维持性血液透析PTH血症患者随机分为两组：血液灌流＋血液透析组（HD＋HP组）和血液透析滤过组（HDF组）,HD＋HP组接受树脂吸附联合血液透析治疗,HDF组接受血液透析滤过治疗,常规测定血清磷和放射免疫法测定中分子毒性物质PTH水平.结果 HDF组及HP＋HD组对于血清磷均能有效清除,且清除率无统计学意义（P＞0.05）.HDF组及HP＋HD组均能有效清除中分子物质PTH,但HDF组清除效果优于HP＋HD组,差异有统计学意义（P＜0.05）.结论 血液透析滤过能有效清除PTH,其对血液透析患者高PTH血症的效果优于血液灌流联合血液透析.

Clinical study on hemodialysis patients with high PTH

Objective To investigate the effect of two different blood purification methods on serum parathyroid hormone(PTH) in chronic hemodialysis patients. Methods 101 patients were randomly divided into two groups:hemodialysis + hemoperfusion group( HD + HP group) and hemodiafiltration group( HDF group). Patients in HD + HP group were treated with resin absorptive devices combined hemodialysis, patients in HDF group treated with hemodiafiltration. Routine determination of serum phosphorus and radioimmunoassay of PTH level were carried out before and after treatment. Results HDF group and HP + HD group were effective for the removal of serum phosphorus,and the clearance rate was no significant difference(P ＞0. 05). HDF group and HP + HD group could all effectively eliminate the middle molecular substance PTH, but the clearance rate of HDF group was better than that of HP + HD group,the difference was statistically significant (P ＜ 0. 05 ). Conclusion HDF could safely and effectively clear PTH and had better effect than HD + HP.