组合型人工肾联合维生素B_1治疗尿毒症不宁腿综合征的临床观察

目的观察组合型人工肾（血液透析联合血液灌流）结合血液透析及维生素B1对尿毒症不宁腿综合征（RLS）患者的治疗效果。方法对25例常规血液透析治疗无效的RLS患者给予每周1次血液灌流联合血液透析,每周2次单纯血液透析,并加用维生素B1口服,30mg,每日3次。于治疗前及治疗1个月、3个月时检测甲状旁腺素（iPTH）、β2-微球蛋白（β2-MG）水平及RLS评分变化,观察该治疗方案的有效率。结果 iPTH、β2-MG水平及RLS评分于治疗1个月已有下降,治疗3个月均显著低于治疗前〔iPTH：（621.54±211.78）vs（915.20±278.32）pg/ml,P〈0.05;β2-MG：（14.37±3.48）vs（21.36±5.83）mg/L,P〈0.05;RLS评分：（3.13±1.24）vs（7.63±1.52）分,P〈0.05〕。治疗有效率达92.0%。结论组合型人工肾结合血液透析及维生素B1是RLS患者的有效治疗方法。

Efficacy of hemoperfusion associated with hemodialysis and vitamin B1 on restless legs syndromes in uremic patients

Objective To observe the efficacy of the combination-mode artificial kidney （hemoperfusion associated with hemodialysis） combined with routine hemodialysis and vitamin B~ on restless legs syndromes （RLS） in uremic patients. Methods Twenty-five patients with RLS in uremic patients who had been treated by routine hemodialysis but were inefficacy were treated by hemoperfusion associated with hemodialysis （once a week） combined with routine pure hemodialysis （twice a week） and vitamin Bi （ 30 mg tid ）. The levels of serum parathyroid hormone （iPTH） and β2-microglobulin （ β2-MG ） were examined, and the change of RLS score was monitored before treatment and after treating for 1 month and 3 months for evalua- ting therapeutic effect. Results Compared with pre-treatment, all the levels of serum iPTH and β2-MG and the RLS score had declining trend after treating for 1 month and lowed significantly after treating for 3 months iPTH： （621.54 ± 211.78 ） vs （915.20 ± 278.32） pg/ml, P 〈 0. 05 ; β2-MG ： （ 14.37 ± 3.48 ） vs （ 21.36 ± 5.83 ） mg/L, P 〈 0. 05 ; RLS score ： （ 3.13 ± 1.24） vs （7.63 ± 1.52 ）, P 〈 0. 05 ]. The effective rate was 92.0%. Conclusions The combination-mode artificial kidney combined with routine hemodialysis and vitamin B1 for treating RLS in uremic patients is a useful therapeutic scheme.