高通量血液透析与低通量血液透析的透析效果比较

目的 比较高通量血液透析(HFHD)、低通量血液透析(LFHD)对维持性血液透析患者的综合疗效.方法 32例维持性血透患者,随机分为高通量血液透析组(n=16)和低通量血液透析组(n=16),分别每2周透析5次,每次4.5h.分别于首次透析前、透析后取血检测患者血清BUN、Cr、K+、Na+、Ca2+、P3++、β2-MG、Alb及iPTH.同时观察患者的临床症状变化情况.治疗1年后复查并比较上述指标.结果 高通量透析组对iPTH及β2-MG的清除高于低通量血液透析组(p＜0.05).两组Urea、Cr清除率及KT/V值无统计学差异(p＞0.05),透析前后两组K+、Na+、Ca2+、P3+无统计学差异(p＞0.05).高通量透析组患者的临床症状较低通量透析组明显改善,血清白蛋白变化无明显差异(p＞0.05).结论 高通量血液透析对中大分子物质的清除明显优于低通量血液透析,并能改善患者的临床症状,不会引起蛋白质过多的丢失,对小分子物质清除与低通量血液透析具有同样的效果.

Comparison of effects between high-flux hemodialysis and low-flux hemodialysis

Objectives To compare the total effect on clearing uremic toxins and changing of clinical symptom between high-flux hemodialysis (HFHD) and low-flux hemodialysis. Methods The patients (n = 32)with maintaining hemodialysis were divided into HFHD group(n = 16) and LFHD group(n = 16) at random. HFHD group and LFHD group was given treatment fifth every two weeks (4. 5 hours per time), respectively. Their plasma levels of BUN 、eatinine(Cr) 、K + 、Na + 、Ca2 + 、P3+ 、β2-microglobulin(β2-MG) 、 albumin(Alb) and iPTH , and so on ,were detected before the treatment and at the end of the treatment. Meanwhile, changing of their clinical symptoms were observed. The data of two groups were compared after one year. Results The clearance rates of β2-MG and iPTH were significantly higher in HFHD group than in LFHD group(p ＜ 0. 05). 2. There were no significant differences in serum urea 、Cr 、KT/V and albumin between two groups(p ＞ 0. 05). 3. There were no significant differences in the improvement of K + 、Na + 、Ca2 + 、P3+ between the two groups(p ＞ 0. 05). 4. The clinical symptoms were significantly improved in HFHD group. Conclusions HFHD is better than LFHD in the clearance of larger molecules such asβ2-MG and iPTH. The clearance of small molecules is the same effect between the two groups. HFHD can improve patient's clinical symptoms and cant lose more Alb.