目的 比较不同血液净化方式对肾性骨病相关指标的影响。方法 选取在我院血液净化中心行维持性血液透析(maintenance hemodialysis,MHD )6个月以上均符合肾性骨病诊断的患者64例,随机分为4组, 即低通量血液透析(HD)、高通量血液透析(HFHD)、血液透析+血液透析滤过(HD+HDF) (1次/周)及血液透析+血液灌流 (HD+HP) (1次/周) ,每组16例,比较各组治疗前及治疗24周后血钙(Ca)、血磷(P)、甲状旁腺激素(PTH)、碱性磷酸酶(ALP)及β2-微球蛋白(β2-MG),并计算钙磷乘积(Ca×P)。结果 HFHD组、HD+HDF组及HD+HP组治疗后与治疗前相比血P、PTH、ALP、β2-MG、Ca×P均显著下降,差异有统计学意义(P<0.05); HD+HDF组治疗后清除血P(1.91±0.19)mmol/L、β2-MG(11.32±2.61)mg/L及PTH(347.21±152.05)pg/ml优于HFHD组(1.98±0.14)mmol/L、β2-MG(17.09±5.60)mg/L及PTH(471.98±123.02)pg/ml,HD+HP组治疗后清除血P(1.92±0.09)mmol/L、β2-MG(12.62±3.34)mg/L及PTH(337.96±142.80)pg/ml也优于HFHD组,差异有统计学意义(P<0.05), HD+HDF组与HD+HP组相比差异无统计学意义;HD组治疗前后血P、Ca×P、PTH、β2-MG水平差异无统计学意义。4组治疗前后血钙水平差异无统计学意义。结论 HFHD组、HD+HDF组、HD+HP组在清除血P、PTH及β2-MG上优于HD组,尤其HD+HDF组、HD+ HP组更优。
Abstract
Objective To compare the effects of different purification methods on elements related to rental osteopathy.Methods Sixty-four patients who had undergone blood purification for six months and had been diagnosed with rental osteopathy at our center were randomly and equally divided into four groups: HD group, HFHD (once a week) group, HD+HDF(once a week) group and HD+HP(once a week) group to compare the changes in the levels of Ca,P, PTH, ALP and β2-MG in each group before treatment and 24 weeks after treatment. Calcium-phosphorus product(Ca×P)was also calculated.Results After treatment, levels of P,ALP,PTH,β2-MG and the product of Ca×P(P<0.05) in the HFHD group HD+HDF group and HD+HP group were significantly decreased. The ability to clean up P(1.91±0.19)mmol/L, β2-MG(11.32±2.61)mg/L and PTH(347.21±152.05)pg/ml in the HD+HDF group was improved compared to P(1.98±0.41)mmol/L, β2-MG(17.09±5.06)mg/L and PTH(471.98±123.02)pg/ml in the HFHD group. Furthermore, the same ability of the HD+HP group was better than that of the HFHD group(P<0.05).However, there was no significant difference between HD+HDF group and HD+HP group. Meanwhile, the levels of P,Ca×P,PTH and β2-MG in HD group did not decrease after treatment. The level of Ca remained unchanged after treatment.Conclusions P, PTH and β2-MG in the HFHD group, HD+HDF group and HD+HP group can be better cleaned up than in the HD group.
关键词
肾性骨病 /
血液透析 /
血液灌流 /
甲状旁腺激素 /
β2-微球蛋白
Key words
rental osteopathy /
hemodialysis /
hemoperfusion /
parathormone /
β2-microglobuhn
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