血液透析滤过和高通量血液透析对尿毒症患者血清瘦素的清除作用

目的　研究血液透析滤过 (HDF)及高通量血液透析 (HHD)对尿毒症维持性血液透析患者血清瘦素的清除作用。方法　 6 0例维持性血透患者 (MHD)随机分为 3组 ,分别行血液透析滤过 (HDF)、高通量血液透析 (HHD)、普通低通量血液透析 (LHD) ,另 15例为正常对照组。放射免疫法检测MHD组血透析前后及对照组血清瘦素浓度。结果　MHD组透前血清瘦素水平较对照组显著升高 (P <0 .0 1) ;HDF组及HHD组透后血清瘦素水平较透前显著下降 (均P <0 .0 1) ;LHD组透后血清瘦素水平与透前比较无显著性差异 (P >0 .0 5 )。结论　血液透析滤过及高通量血液透析能清除部分血清瘦素 ,降低MHD患者的高瘦素血症。

Removal effect of hemodiafiltration and high-flux hemodialysison on serum leptin in uremic patients

Objective:To investigate the removal effect of hemodiafiltration(HDF) and high-flux hemodialysis(HHD) on serum leptin in uremic patients with maintenance hemodialysis.Methods:60 maintenance hemodialysis patients were divided into three groups randomly, being treated with HDF, HHD and low-flux hemodialysis(LHD) respectively. 15 healthy persons were as controls. The pre-dialysis and post-dialysis serum leptin concentration were measured by radioimmunoassay in uremic patients and controls. Results:The levels of serum leptin in patients with MHD were significantly higher than those in control group( P <0.01).The levels of post-dialysis serum leptin in patients with HDF and HHD were significantly lower than those of pre-dialysis( P <0.01, P < 0.01 , respectively). There was no significantly difference in the levels of serum leptin between post-dialysis and pre-dialysis in patients with LHD( P >0.05 ). Conclusion:Hemodiafiltration and high-flux dialysis can remove the serum leptin partly and reduce the hyperleptinemia in uremic patients.