超纯水对维持性血液透析患者营养不良及贫血的影响

目的　探讨超纯水对维持性血液透析患者营养不良及贫血的影响。方法　以 2台美国OSMONICS反渗机改造成二级反渗系统 ,再经微滤器滤过后形成超纯水 ,细菌生长数 <0 1CFU/ml,内毒素浓度 <0 0 3EU/ml。 6 6例无感染的维持性血液透析患者 ,一直应用符合AAMI标准的透析用水及透析液透析 1年～ 4年 ,4 0例患者依靠输血来改善贫血 ,平均输血间隔 (2 4 3± 7 6 )天 ,2 6例使用重组人红细胞生成素和铁剂治疗贫血。其它治疗不变 ,改用超纯水透析 8月 ,检测改用前、后 8月的C 反应蛋白 (CRP)、血清白蛋白 (ALB)、血红蛋白 (Hb)、红细胞压积 (HCT)、血清尿素氮 (BUN)、血清肌酐 (Scr)、甲状旁腺素 (iPTH)、计算体重矫正标准化蛋白分解率 (nPCR)、干体重和进行上臂肌围 (MACA)测定。结果　CRP水平显著下降 (P <0 0 1) ,ALB、Hb、HCT、干体重、MACA水平均显著升高 (P <0 0 5 ) ,nPCR显著升高 (P <0 0 1) ,平均输血间隔显著延长 (P <0 0 5 )。结论　超纯水能显著改善维持性血液透析患者营养状况及贫血。

Effects of ultrapure water on malnutrition and anemia of maintenance hemodialysis patients

Objective To investigaste the effects of ultrapure water on the malnutrition and anemia of maintenance hemodialysis patients.Methods There were 66 cases without infection selected from the maintenance hemodialysis patients whose dialysis water is 'pure water',which coincide to the code of AAMI.Levels of their CRP,ALB,Hb,HCT,BUN,Scr,iPTH,nPCR,dry weight,MACA were tested.After 8 months when the dialysis water had changed into 'ultrapure water' and the other therapy hadn't changed,above-mentioned markers were tested again.Results After the dialysis water changed,the levels of CRP were significantly decreased,but the levels of ALB,dry weight,MACA,Hb,HCT,nPCR were all significantly increased.Their average of blood transfusion interval was elongated significantly.Conclusion Ultrapure water can ameliorate nutritional status and anemia in the maintenance hemodialysis patients.