血液滤过治疗尿毒症皮肤瘙痒临床研究

目的探讨血液滤过治疗尿毒症患者皮肤瘙痒临床疗效及其机制。方法将尿毒症维持血液透析伴有皮肤瘙痒的32例病人,随机分为两组。对照组(16例)继续维持血液透析,治疗组(16例)在血液透析基础上联机应用血液滤过,每周2~3次,每次4 h,疗程1个月,记录皮肤瘙痒消失例数,治疗前后分别查血β2微球蛋白(β2-MG)、甲状旁腺激素(PTH)。结果治疗后治疗组13例皮肤瘙痒消失;对照组无1例皮肤瘙痒消失;血中β2-MG,PTH治疗组下降明显,与对照组比较,P<0.05。结论血液滤过能改善尿毒症皮肤瘙痒症状,亦可降低血中β2-MG,PTH浓度。

Clinical Research on Hemofiltration for Treatment of Skin Itch in Uremia Patients

Objective To investigate the clinical influence of hemofiltration on uremia patients'skin itch.Methods Analysis was conducted on the ureima patients treated with continual hemodialysis covering a period from March 2004 to December 2006 in my hospital,among whom the 32 patients suffering from skin itch were further divided into two groups on randomization principle.In therapeutic group(n=16;9 males,7 females),the patients'average age was 56.8±21.3(mostly 20-78) years,and in control group(n=16;10 males,6 females) the counterpart was 57.9±20.8(mostly 21-79).The patients in the control group were treated continually with hemodialysis,and those in the therapeutic group were treated additionally with hemofiltration besides hemodialysis.The hemofiltration lasting for one month as a course was performed 2-3 times a week(4 hours per time).Before and after the treatment,the serum β2-microglobin(β2-MG) and parathyroid hormone(PTH) were monitored respectively.Results After the treatment,the time,within which the skin itch symptom disappeared,was significantly shorter,and the levels of β2-MG and PTH in serum were significantly lower in the therapeutic group than in the control group.Conclusion Hemofiltration can not only improve the skin itch symptom of uremia patients,but decrease the levels of β2-MG and PTH in serum as well.