高通量透析对维持性血液透析患者高血压及甲状旁腺激素的影响

目的探讨高通量血液透析（high permeable hemodialysis,HPD）对维持性血液透析（maintenance hemodialysis,MHD）患者高血压及甲状旁腺激素（parathyroid hormone,PTH）的影响。方法选择安徽医科大学第三附属医院血液净化中心行维持性血液透析的患者52例。高通量透析组（HPD组）和普通透析组（LPD组）各26人。HPD组采用费森尤斯公司FX60高通量透析器。LPD组采用费森尤斯公司F7透析器。两组每周透析时间均为12 h。治疗时间6个月,观察两组病人治疗前后收缩压,平均动脉压,PTH及钙磷乘积。结果两组患者入选前血压、心率、钙磷乘积和PTH指标均无统计学差异（P〉0.05）。治疗6个月后,LPD组收缩压、平均动脉压、心率、钙磷乘积和PTH指标与透析前相比无统计学差异（P〉0.05）。与LPD组相比,HPD组收缩压和平均动脉压明显降低（P〈0.05）,但钙磷乘积和PTH无统计学差异（P〉0.05）。结论高通量透析模式可以有效改善维持性血液透析病人高血压,但对于中分子物质PTH影响与LPD组相比没有明显差异。

Effects of high permeable hemodialysis on hypertension and parathyroid hormone in patients with maintenance hemodialysis

Aim To observe the effect of high permeable hemodialysis(HPD) using different membrane on hypertension and parathyroid hormone in patients with maintenance hemodialysis.Methods 52 patients with maintenance hemodialysis were randomly divided into two groups.26 cases were treated with HPD using F60 dialyser(HPD group),and 26 cases were treated with low permeable hemodialysis(LPD)using F7 dialyser(LPD group).Results At the beginning of hemodialysis,there were no significant differences in blood pressure,heart rate,calcium-phosphorus product and PTH between the 2 groups(P>0.05).After the dialysis for six months,In LPD group,blood pressure,heart rate,calcium-phosphorus product and PTH remained unchanged.Systolic pressure and mean arterial pressure levels were significantly lower in HPD group compared with those in LPD group(P<0.05),but the changes of calcium-phosphorus product and PTH levels did not reach statistical significance(P>0.05).Conclusion HPD is effective in improving hypertension in hemodialysis patients,but the changes of calcium-phosphorus product and PTH levels don’t reach statistical significance.