高通量透析对糖尿病肾病血液透析患者矿物质和骨代谢的影响

目的：观察高通量血液透析对糖尿病肾病维持性血液透析患者矿物质和骨代谢的影响。方法选择糖尿病肾病维持性血液透析60例，将60例按照数字表法随机分为高通量透析治疗组和低通量透析治疗组，治疗6个月，分别观察2组治疗前后血钙、血磷、碱性磷酸酶、甲状旁腺素、25羟基维生素D3等指标的变化。结果高通量透析组的磷、钙磷乘积、甲状旁腺素水平分别为（1.52±0.50） mmol／L、（3.05±1.19） pg／L、（368.61±235.32） pg／L，较治疗前（（1.78±0.55） mmol／L、（3.94±1.31） pg／L、（427.45±288.93）pg／L）显著下降（ P＜0.05），钙、25羟基维生素D3水平分别为（2.3±0.16） mmol／L、（21.64±8.51）nmol／L，较治疗前（（2.12±0.18）mmol／L、（16.77±7.69）nmol／L）显著升高（P＜0.05），而低通量透析组治疗前后血钙、血磷、碱性磷酸酶、甲状旁腺素、25羟基维生素D3差异均无统计学意义（ P＞0.05）。结论与低通量透析相比，高通量透析可改善糖尿病肾病维持性血液透析患者矿物质和骨代谢紊乱。

Effect of high-flux hemodialysis on mineral and bone metabolism of patients with diabetic kidney disease undergoing maintenance hemodialysis

Objective To investigate the effect of high-flux hemodialysis on mineral and bone metabo-lism（ MBD） in diabetic kidney disease patients with maintenance hemodialysis .Methods 60 cases with diabetic kidney disease undergoing maintenance hemodialysis were studied and they were randomly divided into two groups according to the number table method .Patients in each group were treated using either high-flux dialyzer or low-flux dialyzer for 6 months.Blood calcium（Ca）, blood phosphorus（P）, calcium＊phosphorus（Ca＊P）, alkaline phosphatase（AKP）, parathyroid hormone（PTH）, and 25 hydroxy vitamin D3（25-OH-D3）,etc were determined at the start and end of the study .Results In high flux dialysis group , serum P, serum Ca＊P, and PTH levels was（1.52 ±0.50）mmol/L,（3.05 ±1.19）pg/L and（368.61 ±235.32）pg/L respectively, which was significantly decreased than before treatment （（1.78 ±0.55）mmol/L,（3.94 ±1.31）,（427.45 ±288.93）pg/L） （P〈0.05）, while serum Ca, and 25-OH-D3 levels were（2.3 ±0.16）mmol/L and（21.64 ±8.51）nmol/L respectively, which were increased significantly than before treatment （（2.12 ±0.18）mmol/L,（16.77 ±7.69） nmol/L）（P〈0.05）, yet in low flux dialysis group serum Ca, P, AKP, PTH, and 25-OH-D3 didn＇t change sig-nificantly before and after treatment （ P〉0.05） .Conclusion High-flux dialyser provides a better effect on MBD for patients with diabetic kidney disease undergoing maintenance hemodialysis .