血液透析与血液滤过对终末期肾病中性粒细胞活性影响的对比研究

目的对比血液透析(HD)与血液滤过(HF)治疗过程中、治疗后对中性粒细胞(PMN)活性的影响及对溶质的清除效果。方法从180例终末期肾病(ESRD)患者中随机选取20例观察比较这两种血液净化方式治疗前、刚过透析器后、治疗结束后对中性粒细胞碱性磷酸酶(NAP)的活性及血尿素氮(BUN)、血肌酐(Scr)、尿酸(UA)、血磷水平。结果 HF组治疗过程中NAP积分下降率均高于HD组,且以刚过透析器后积分的下降率最为明显。HD组BUN、Scr、UA的下降率均高于HF组(P0.05)。两组血磷下降率差异均无统计学意义(P0.05)。结论 HF较HD更能改善中性粒细胞的活性,且以刚过透析器后的影响最为显著。但HD对小分子毒素的清除效果比HF更佳。

Comparative study between hemodialysis and hemofiltration in affecting neutrophils activity of end-stage renal disease

Objective To compare the effect on polymorphonuelear neutrophils （PMN） activity and solute clearance between hemodialysis （HD）and hemofiltration（HF） therapy. Method Out of 180 cases of end-stage renal disease （ESRD） patients, 20 were chosen to undergo HD and HF alternatively. Observation was made at before, right through, the end of treatment in terms of neutrophil alkaline phosphatase （NAP） activity, blood urea nitrogen （BUN）, serum creatinine （Set）, uric acid （UA）, and blood phosphorus level. Results During the treatment, the NAP scores reduce rate was higher in HF group than in HD group, and the change peaked at right through the dialyzer in both groups. Reduce rates of BUN, Scr, and UA were higher in HD group than in HF group （ all P 〈 0. 05 ）. No significant difference was observed in blood phosphorus level between the two groups. Conclusion HF can improve the activity of neutrophils better than HD, and the effect culminates at right through dialyzer, while HD can scavenge the smaU molecule toxins much better than HF.