不同血液净化方法对慢性肾衰竭维持性血液透析患者血清β2-微球蛋白的影响

目的探讨不同血液净化方法对慢性肾衰竭维持性血液透析（MHD）患者血清β2微球蛋白（BrMG）的清除效果。方法将40例慢性肾衰竭MHD患者随机分为四组：血液透析（HD）组，高通量血液透析（HFD）组，血液透析滤过（HDF）组，HD＋血液吸附（AP）组，每组各10例。记录患者治疗前后血清β2-MG测得值并进行组内和组间统计学比较。结果HD组第1次血液净化后β2-MG测得值（53．49±1．15）mg／L]较第1次血液净化前（基线值）（49．10±2．31）mg／L]上升但差异无统计学意义（P〉0．05），6个月血液净化后β2-MG测得值（55．63±1．30）mg／L]较基线值上升且差异有统计学意义（P〈0．05）。HFD组、HDF组和HD＋AP组第1次血液净化后及6个月血液净化后β2-MG测得值较基线值均有明显下降趋势（P〈0．05）。并且HD＋AP组6个月血液净化后β2-MG测得值较HFD组和HDF组下降趋势更为明显（P〈0．05）。结论HD对β2-MG无清除效果，HFD、HDF和HD＋AP能有效清除β2-MG，并且6个月后HD＋AP清除β2-MG效果更佳。

Clinical investigation of different blood purification techniques on clearing serum beta2-microglobulin of chronic renal failure maintenance hemodialysis patients

Objective To investigate the clear effect of different blood purification techniques on the serum beta2-microglobulin （β 2-MG） of chronic renal failure maintenance hemodialysis patients. Methods Forty chronic renal failure maintenance hemodialysis patients were randomly divided into four groups： hemodialysis group （HD group）, high flux dialysis group （HFD group）, hemodiafiltration group （HDF group）, hemodialysis and absorption group （HD＋AP group）. The serum β 2-MG levels of the four groups were determined and compared before with after the therapy. Results The difference between the serum β 2-MG in HD group detected at the first day before and after the therapy was insignificant difference （53.49 ± 1.15 ） mg/L vs （49.10 ± 2.31 ） mg/L ] （P 〉 0.05 ）. The difference between the serum β 2-MG in HD group detected at the first day before and after the therapy six months later （55.63 ± 1.30） mg/L] was significant difference （P 〈0.05）. The serum levels at the first day and six months later after the therapy detected in HFD group, HDF group and HD＋AP group were significantly decreased compared with those of the first day before the therapy （P〈 0.05）. Furthermore,the serum β 2-MG level decreased in HD＋AP group was more significant than HFD group and HDF group at six months later （P 〈0.05）. Conclusions Hemodialysis can not clear the serum β 2-MG. High flux dialysis, hemodiafiltration and resin absorptive devices associated hemodialysis can clear β 2-MG effectively, while resin absorptive devices associated hemodialysis has the better effection after six months.