不同透析膜对维持性血液透析患者血磷清除效果的研究

目的　了解不同的透析膜对维持性血液透析患者血磷的清除情况。方法　将2 6例进行维持性血液透析的高磷血症患者分为3组,分别使用聚砜膜(1.3m2 )、三醋酸纤维膜(1.5m2 )和血仿膜(1.7m2 )透析,比较透析前后血磷的下降率(单位膜面积)以及透析2个月后血磷及钙磷乘积的变化。结果　去除膜面积因素后,聚砜膜和三醋酸纤维膜与血仿膜比较,单次透析血磷的下降率(单位膜面积)差异均有显著性(P<0 .0 5 ) ,但聚砜膜和三醋酸纤维膜比较差异无显著性(P >0 .0 5 )。使用2个月后比较血磷水平及钙磷乘积,三醋酸纤维膜组透析前血磷及钙磷乘积均较前显著下降(P <0 .0 5 ) ,而聚砜膜组和血仿膜组均较前无明显改善(P >0 .0 5 )。结论　膜面积相等的情况下,聚砜膜和三醋酸纤维膜对磷的清除优于血仿膜,前两者之间差异无显著性。使用聚砜膜和三醋酸纤维膜并适当增大膜面积可更大程度地清除血磷,同时可降低钙磷乘积。

Effect of different dialyzer membranes on serum phosphorus level in maintenance hemodialysis patients

Objective To find out the effect of different dialyzer membranes on serum phosphorus level in maintenance hemodialysis patients.Methods Twenty-six hemodialysis patients with hyperphosphatemia were randomly divided into three groups:polysulfon membrane(n=9),trichloroacetate cellulose membrane(n=9),hemophane membrane (n=8).The serum phosphorus and calcium concentrations were measured at the time before and after the hemodialysis with different kinds of dialyzer membranes.Results The descent rate of serum phosphorus in the patients of polysulfon membrane group and trichloroacetate cellulose membrane group were significantly higher than those in the patients of hemophane membrane group(P<0.05). The significant dropness of serum phosphorus concentrations and calcium-phosphorus product were observed after 2 months hemodialysis treatment with trichloroacetate cellulose membrane (P<0.05).Conclusions Compared with hemophane membrane,polysulfon membrane and trichloroacetate cellulose membrane have a higher clearance rate.Using polysufon and trichloroacetate cellulose membranes and properly enlarging their area may have beneficial effect in controlling serum phosphorus level and calcium-phosphorus product.