应用FX60透析器对维持性血液透析患者慢性并发症的影响

目的 探讨应用高通量透析器(FX60)对维持性血液透析患者慢性并发症的影响.方法 30例透析龄人于2年的稳定维持性血液透析患者,年龄28～78岁,分别使用低通量和高通量透析器(FX60)透析1年,观察并比较血压、血红蛋白、总蛋白、白蛋白、血脂、个段甲状旁腺激素、尿素清除指数(Kt/V)、血钙、磷、钙磷乘积和血B_2微球蛋白清消除率的变化.结果 低通最和高通量透析对小分子物质清除处异无统计学意义(P>0.05).使用FX60透析器行高通量透析1年后,患者血红蛋白由(103.9±18.1)g/L升至(111.8±11.5)g/L,全段甲状旁腺激素由(525.2±695.6)pg/ml下降到(437.3±417.2)pg/ml,透析前平均动脉压自(106.1±7.5)mmHg(1mmHg=0.133kpa)下降到(104.5±7.3)mmHg,高密度脂蛋自由(0.91±0.27)mmol/L升至(1.02±0.28)mmol/L,差异均有统计学意义(均P<0.05);而低通量透析上述指标无明量变化.FX60透析器单次透析血B_2微球蛋自消除率为(35.9±3.8)%.结论 用FX60透析器行高通量透析有利于消除中分子物质,改善透析患者的肾性贫血、高血压和继发性甲状旁腺功能亢进.

The application of FX60 dialyser on chronic complications in maintenance hemodialysis patients

Objective To investigate the application of FX60 dialyser on chronic complications in maintenance hemodialysis patients. Methods A total of 30 patients aged from 28 to 78 years old and on hemodialysis for more than 2 years were switched to FX60 dialyzer for hemodialysis for one year. Their clinical and biochemical indicators, including blood pressure, hemoglobin, albumin, intact parathyroid hormone （iPTH）, calcium, lipids, calcium and phosphorus product, Kt/V and ＇-MG clearance rate, were obtained before and after the application of FX60 dialyser. Results After the dialysis with FX60 dialyser for one year, hemoglobin increased from （103.9±18.1）g/l to （111.8±11.5）g/l （P0.05）, iPTH declined from （525.2±695.6）pg/ml to （437.3±417.2）pg/ml （P0.05）, mean arterial blood pressure lowered from （106.1±7.5）mmHg to （104.5± 7.3）mmHg （P0.05）, and high-density lipoprotein （HDL） increased from （0.91±0.27）mmol/l to （1.02± 0.28）mmol/l （P0.05）. There were no significant differences in clearance rates for small molecules between low-flux dialysis and high-flux dialysis. ＇-MG clearance rate was （35.9±3.8）% after one dialysis session using FX60 dialyzer. Conclusion High-flux hemodialysis with FX60 dialyser effectively improves ＇-MG clearance, renal anemia, hypertension, and secondary hyperparathyroidism in maintenance hemodialysis patients.