血液透析与血液透析结合不同频率血液滤过的疗效比较

目的比较血液透析与血液透析结合不同频率血液滤过（血液透析滤过）的疗效。方法将116例维持性血液透析患者采用随机数字表法分为3组，分别为对照组（34例）、研究1组（37例）和研究2组（45例）。对照组患者每周3次血液透析；研究1组患者每2周5次血液透析、1次血液透析滤过（血液透析：血液透析滤过为5：1）；研究2组患者每周2次血液透析、1次血液透析滤过（血液透析：血液透析滤过为2：1）。观察透析时并发症发生率、透析前后血尿素氮、肌酐、血磷、甲状旁腺激素（PTH）的水平，计算尿素清除指数（K11／V）和蛋白分解代谢率（PCR）。结果3组患者尿素氮、肌酐、KT／V、PCR差异无统计学意义。其中研究2组和研究1组血磷清除率、PTH清除率优于对照组分别为（50．5±2．1）％、（32．6±2．7）％比（14．3±4．0）％，（40±4）％、（17±6）％比（11±4）％]，差异均有统计学意义（P〈0．05或P〈0．01），研究2组优于研究1组，差异均有统计学意义（t9〈0．05或P〈0．01）。结论血液透析与血液透析滤过2：1的血液净化方式在维持性血液透析患者中能取得较好的透析效果，可提高患者生活质量。

Comparative study on the sustaining hemodialysis and hemodialysis combined with different frequency hemodiafiltration

Objective To compare the complication of sustaining hemodialysis （HD） by different modality of HD： HD combined with hemodiafiltration（HDF） （HD/HDF = 5：1 ） and HD/HDF 2： 1. Methods The 110 cases were randomly assigned into three groups ： HD group （ 34 cases ）, HD/HDF 5 ： 1 group （ 37 cases ）, HD/HDF 2 ： 1 group（45 cases）. The patients of HD group were given hemodialysis three times a week, patients of HD/HDF 5：1 group were given blood dialysis three times a week and hemodialysis and hemofihration once every two weeks （ hemodialysis： hemodialysis and hemofihration 5：1 ）, patients of HD/HDF 2：1 group were given blood dialysis 2 times a week, once weekly hemodialysis and hemofihration （ blood dialysis ： hemodialysis and hemofihration 2 ： 1 ）. The incidence of complication were observed during treating, and blood nitrogen, creatinine, phosphonium, parathyroid were detected before and after hemodialysis. Results Phosphate removal rate and parathyroid clearance in HD/HDF 2：1 group, and HD/HDF 5：1 group were significantly higher than those in HD group （50. 5±2. 1）%, （32.6± 2. 7）% vs （14.3 ±4.0）%, （40 ±4）%, （17±6）% vs （11±4）%, P 〈0.05 orP〈0.01], and those in HD/HDF 2：1 group were also higher than those in HD/HDF 5：1 group（ P 〈 0.05 or P 〈 0.01 ）. There were no statistically significant differences of blood urea nitrogen, creatinine, KT/V, PCR in three groups of patients. Conclusion Hemodialysis and hemofiltration 2：1 blood purification in hemodialysis patients is worth promotion.