不同血液净化方式对终末期肾脏病患者不宁腿综合征的影响

目的 探讨不同血液净化方式对终末期肾脏病（ESRD）患者不宁腿综合征（RLS）的影响.方法 根据国际RLS委员会的诊断标准对ESRD伴RLS的患者进行RLS评分,将符合条件的26例患者随机分为两组,血液透析灌流（HDP）组：采用每周2次血液透析（HD）,1次HDP治疗;血液透析滤过（HDF）组：采用每周2次HD,1次HDF治疗,治疗3个月.观察患者甲状旁腺激素（iPTH）、RLS评分的变化.结果 HDP组治疗后RLS评分较前明显下降（P＜0.01）,HDF组治疗后RLS评分较前下降（P＜0.05）,但HDP组下降幅度明显大于HDF组（P＜0.05）;治疗后HDP组iPTH明显下降（P＜0.05）,HDF组治疗前后无明显变化（P＞0.05）.结论 HDP及HDF两种血液净化方式均能改善ESRD患者的RLS症状,但HDP效果更佳.两者改善RLS症状的机制除与大分子毒素清除有关外,中分子毒素如炎症介质等的清除可能也起一定的作用.

The effect of different methods of blood purification to restless leg syndrome of end stage renal disease patients

Objective To explore the influence of different methods of blood purification to restless leg syndrome （RLS） of End stage renal disease patients （ESRD）. Methods 26 cases of ESRD patients who were diagnosed RLS according to diagnostic criteria from International Committee of RLS were randomly divided into the hemodialysis hemoperfusion （HDP） group （twice HD per week and once HDP per week） and hemodiafiltration （HDF） group （twice HD per week and once HDF per week）,the course was three months.The changes of parathormone （iPTH） level and RLS score were ob- served. Results After the treatment,the iFrH level significantly decreased in the HDP group （P〈0.05） while it had no significant difference in the HDF group （P〉0.OS）,the RLS score were both significantly decreased in the HDP group （P〈0.01） and he HDF group （P〈0.05）,but the decrease range in the HDP group was significantly higher than it in the HDF group （P〈0.05）. Conclusion The methods of HDP and HDF can both improve the symptom of RLS,but the HDP is better.The mechanism of improving the symptom of RLS by HDP and HDF may be related to the clearance of middle molecule toxins such as inflammatory mediators in addition to he clearance of large molecule toxins.