不同血液透析方式对慢性肾衰竭患者β2微球蛋白、瘦素、血红蛋白水平的影响及安全性分析

目的：探讨不同血液透析方式对慢性肾衰竭患者β2微球蛋白（β2‐MG）、瘦素及血红蛋白（Hb）水平的影响，并分析其安全性。方法选取2014年1月至2015年1月在重庆医科大学附属永川医院住院行血液透析的慢性肾衰竭患者60例，根据不同的治疗方法将其分为普通血液透析组（普通HD组）、血液透析滤过组（HDF组）、普通血液透析加血液灌流组（HD＋HP组），检测患者血标本中瘦素、β2‐MG、Hb及促红细胞生成素（EPO）水平，观察其不良反应发生率，评估其生活质量，并进行比较分析。结果与透析前比较，首次透析及透析6个月后，3组患者血标本中瘦素、β2‐MG水平均降低，且HD＋HP组水平最低，差异均有统计学意义（P＜0．05）；与普通HD组比较，HDF组、HD＋HP组首次透析及透析6个月后血标本Hb、EPO水平均升高，差异均有统计学意义（P＜0．05）；透析后，HD＋HP组并发症的发生率低于普通HD组与HDF组，差异均有统计学意义（P＜0．05）；治疗后HDF组、HD＋HP组的各项生活质量评分均优于普通HD组，且HD＋HP组的各项生活质量评分较高，差异均有统计学意义（P＜0．05）。结论对慢性肾衰竭患者采用HP法治疗，能够更好地降低血液中瘦素、β2‐MG水平，不影响Hb水平，且并发症的发生率低，治疗后患者的生活质量明显提高。

Effect of different hemodialysis modes on serum levels of beta 2 microspheres,leptin and hemoglobin in patients with chronic renal failure and safety analysis

Objective To investigate the influence of different hemodialysis modes on serum levels of beta 2 microspheres , leptin and hemoglobin(Hb) in the patients with chronic renal failure (CRF) and to analyze its safety .Methods Sixty inpatients with CRF in our hospital from January 2014 to January 2015 were selected as the research subjects and divided into the common he‐modialysis group (common HD groups) ,hemodialysis filtration group(HDF group) and the common hemodialysis plus hemoperfu‐sion group(HD+ HP group) according to different treatment methods .The levels of serum leptin ,beta 2 microspheres (β2‐MG) , Hb and erythropoietin (EPO) were measured .The occurrence rates of adverse reactions were observed .The living quality was eval‐uated and conducted the comparative analysis .Results Compared with before hemodialysis ,the levels of serum leptin and β2‐MG levels after the first time of hemodialysis and 6‐month hemodialysis in the three groups were decreased ,moreover the levels in the HD+ HP group were the lowest ,the differences were statistically significant (P<0 .05) ;compared with the common HD group , the levels of Hb and EPO after the first time of hemodialysis and 6‐month hemodialysis in the HDF group and HD+ HP group were increased ,the differences were statistically significant (P<0 .05);the incidence rate of complications after hemodialysis in the HD +HP group was lower than that in the common HD group and the HDF group ,the differences were statistically significant (P<0 .05);the living quality scores of each item after hemodialysis in the HDF group and HD + HP group were superior to those in the common HD group ,moreover the living quality scores in each item in the HD + HP group were higher ,the differences were statisti‐cally significant(P<0 .05) .Conclusion Adopting the HP therapy in the patients with CRF can better reduce the levels of blood leptin andβ2‐MG without affecting the Hb level ,moreover with low occurrence rate of complications ,and the patient′s living quali‐ty is significantly improved after treatment .