探讨不同血液净化方式对维持陛血液透析患者抵抗素及甲状旁腺素的清除作用

目的探讨不同血液净化方式对维持性血液透析（maintenance hemodialysis，MHD）患者抵抗素及甲状旁腺素（parathyroid hormone，PrrH）的清除及意义。方法选择MHD患者61例，按随机数字表法分为联机血液透析滤过（on—line hemodiafihration，OL—HDF）组31例和血液透析（hemodialysis，HD）联用血液灌流（hemoperfusion，HP）组30例。采用ELISA方法检测治疗前后患者抵抗素水平，同时测定血尿素氮（blood urea nitrogen，BUN）、肌酐（creatinine，Cr）、尿酸（uric acid，UA）、血磷、PTH浓度，计算清除率。结果OL—HDF组和HD＋HP组患者治疗前临床指标基线水平差异均无统计学意义（P均〉0．05）；OL—HDF组和HD＋HP组患者治疗后BUN、Cr、UA、血磷、阳H及抵抗素较治疗前均显著下降，且笨砰均育统计学意义（P均〈0．01）。OL-HDF组患者抵抗素、PTH、BUN、Cr、UA、血磷清除率均高于HP＋HD组，且除PTH外差异均有统计学意义（P均〈0．05）。结论OL—HDF和HP＋HD均能清除抵抗素和PTH前者对抵抗素清除率更高。

The investigation of the clearance of different blood purification methods on resistin and parathyroid in patients with maintenance hemodialysis

Objective To investigate the removal of resistin and parathyroid hormone（PTH） and significance with different type hemopurification techniques for maintenance hemodialysis（MHD） patients. Methods A total of 61 MHD patients were selected and randomized into on-line hemodiafihration group（OL-HDF, n=31） and hemodialysis with hemoperfusion group （HD＋HP, n= 30）. Serum resistin were detected by ELISA method, The levels of blood urea nitrogen（BUN）, creatinine（Cr）, uric.acid（UA）, blood phosphorus and PTH levels were measured. The clearance were calculated. Results There was no statistical significance in the difference of baseline level of clinical index between OL-HDF group and HD＋HP group （Pall〉 0.05）. The levels of BUN, Cr, UA, PTH, blood phosphorus and resistin after treated were decreased significantly than before treated in both OL-HDF group and HD＋HP group and the differences all had statistical significance （Pall〈 0.01）. The clearance of BUN, Cr, UA, PTH, blood phosphorus and resistin in OL-HDF group were higher than in HD＋HP group, and the differences all had statistical significance except PTH （Pall〈 0.05）. Conclusion Both of OL- HDF and HD＋HP can efficiently eliminate resistin and PTH, but OL-HDF is better than HD＋HP in the efficacy of eliminating resistin.