血液透析滤过与血液透析对维持性血液透析患者疗效的比较

目的比较联机血液透析滤过（OL-HDF）与常规血液透析（RHD）对维持性血液透析（MHD）患者的临床疗效。方法将入选的60例MHD患者按随机排列表法分为两组,HDF组30例行后稀释法OL-HDF,HD组30例行RHD治疗。观察治疗前后及组间并发症发生情况,以及甲状旁腺素（PTH）、β2-微球蛋白（β2-MG）、超敏C反应蛋白（hs-CRP）、Kt/V值的变化。结果 OL-HDF可减少MHD患者的顽固性皮肤瘙痒、周围神经病变、慢性骨痛等并发症;治疗6个月后HDF组血清PTH、β2-MG、hs-CRP水平较HD组显著降低,而Kt/V值变化差异无统计学意义。结论 OL-HDF能更好地清除尿毒症毒素,预防和减少透析相关并发症的发生,明显改善MHD患者微炎症状态,提高患者治疗效果及生活质量。

Comparison of efficacy of Hemodiafiltration and Hemodialysis on Maintenance Hemodialysis Patients

Objective To compare the efficacy of on-line hemodiafiltration（OL-HDF） and regular hemodialysis（RHD） on maintenance hemodialysis（MHD） patients.Methods 60 MHD patients were selected randomly,30 patients among them received OL-HDF treatment and the other half of the patients were under RHD treatment.The clinic symptoms were observed and compared before and after treatment,as well as the concentration of parathyroid hormone（PTH）,β2-microglobulin（β2-MG）,high sensitivity C-reactive protein（hs-CRP） in serum,and Kt/V.Results OL-HDF can reduce complications in MHD patients,such as obstinate pruritus,peripheral neuropathy,chronic ostealgia,and so on;the concentration of PTH,β2-MG,and hs-CRP of patients were reduced remarkably post 6 months of treatment.These observations were significant difference between the two groups except Kt/V.Conclusions OL-HDF can remove the uremic toxins from blood more effectively,prevent and reduce the rate of hemodialysis-related complications,improve the micro-inflammatory status and clinical symptoms as well as the quality of MHD patients′ lives.