血液透析联合血液灌流治疗慢性肾衰竭并发继发性甲状旁腺功能亢进临床观察

目的探讨终末期肾衰竭患者运用维持性血液透析和血液透析联合血液灌流治疗慢性肾衰竭并发继发性甲状旁腺功能亢进（简称甲旁亢）的临床效果及对患者营养状况、肾功能、血压、C-反应蛋白（CRP）等的影响。方法将44例慢性肾衰竭并发继发性甲旁亢维持性血液透析患者随机分为常规血液透析组和血液透析联合血液灌流组，记录入组前两组患者透前收缩压、舒张压，透后收缩压、舒张压，透前血红蛋白、清蛋白、肌酐、尿素氮，血清钙、磷、甲状旁腺激素、β2-微球蛋白（β2-MG）、CRP水平，6个月后重复检查，记录结果。结果两组患者透析6个月后，透前收缩压、舒张压，透后收缩压、舒张压、清蛋白、血清钙、CRP基线情况相似，差异无统计学意义（P〉0．05）。血液透析联合血液灌流组血红蛋白水平较治疗前升高，血清磷、甲状旁腺激素、β2-MG水平较血液透析组升高，差异有统计学意义（P〈0．05）。结论血液透析联合血液灌流能更好地降低血清磷、甲状旁腺激素、β2-MG水平，改善慢性肾衰竭并发继发性甲旁亢症状，同时还能改善患者贫血状态。

Cinical observation of hemodialysis combined with hemoperfusion in treatment of chronic renal failure concurrent with secondary hyperparathyroidism

Objective To explore the clinical effect of maintenance hemodialysis （MHD） method and hemodialysis com- bined with hemopeffusion method in treating chronic renal failure （CRF） concurrent with secondary hyperparathyroidism for patients with end-stage renal disease, and the influence on patients＇ nutriture,renal function, blood pressure, C-reaction protein （CRP） and so on. Methods 44 MHD cases of CRF combined with secondary hyperparathyroidism were randomly divided into routine hemodialysis group and hemoperfusion combined with hemodialysis group. Systolic pressure and diastolic pressure before and after dialysis in the two groups were recorded, meanwhile, the hemoglobin, albumin, creatinine, urea nitrogen, serum calcium and phos- phorus, parathyroid hormone, serum β2-microglobulin （β2--MG）, CRP level before dialysis were also recorded. Repeated exami- nation were conducted after 6 months,and the results were recorded. Results After 6 months dialysis treatment in the two groups, systolic blood pressure and diastolic blood pressure before and after dialysis, albumin, serum calcium, baseline of CRP in the two groups were relatively similar without statistically significant difference （P〉O.05）. In hemodialysis combined with hemop- effusion group ,hemoglobin level after treatment was higher than that before treatment ,and the levels of serum phosphorus, parathyroid hormone and β2-MG were higher than those in hemodialysis group with statistically significant difference （P〈0.05）. Conclusion Hemopeffusion combined with hemodialysis can reduce the levels of serum phosphorus,parathyroid hormone and β2-MG better,improve the symptoms CRF concurrent with secondary hyperparathyroidism and improve the anemia in hemodialysis patients.