高通量血液透析联合血液灌流对血清PTH和ALB的影响.pdf

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1、·临床研究·中国现代医生2014年12月第52卷第36期高通量血液透析联合血液灌流对血清PTH和的影响刘芳张晓丽李敦彤韩晓燕付丽莉刘沫史建春刘洪卫罗瑞哈尔滨市第四医院急诊科，黑龙江哈尔滨150026【摘要】目的探讨高通量血液透析(HFHD)联合血液灌流(HP)对血清甲状旁腺素(PTH)和血清白蛋白(ALB)的影响。方法选取30例维持性低通量血液透析合并继发性甲状旁腺功能亢进的患者，随机分为LFHD和HFHD+HP两组，每组各15例，LFHD组予常规低通量血液透析，每周三次；HFHD+HP组予每两周5次常规低通量透析，每两周～次HFHD+HP治疗，于0个月、12个月分别检测两组的血清Ca、p3

2、~iPTH、ALB的浓度。结果治疗12个月后，两组比较发现：HFHD+HP组的iH明显下降，ALB明显升高(P<0．05)，LFHD组的iH、ALB无明显变化(P>0．05)；两组治疗后比较，HFHD+HP组的P，hs—CRP明显降低，差异有统计学意义(P<0．05)，Ca差异无统计学意义。结论HFHD联合HP治疗能有效清除MHD患者的H，长期应用可以升高血清ALB，改善营养状态。【关键词1高通量血液透析；血液灌流；甲状旁腺素；血清白蛋白【中图分类号】R459．2【文献标识码】B【文章编号】1673—9701(2014)36—0026—04Efectsofhigh—nuxhemodialys

3、iscombinedwithhemoperfusiononserumPTHandALBinmaintenancehemodialysispatientsLIUFangZHANGXiaoliLIDuntongHANXiaoyanFULiliLIUMoSHIfianchunLIUHongweiLUORuiDepartmentofEmergency，theFourthHospitalofHarbinCity，Harbin150026，China[Abstract]ObjectiveToinvestigatetheeffectofhigh-fluxhemodia1ysis(HFHD)combined

4、withhemoperfusion(HP)onparathyroidhormone(PTH)andserumalbumin(ALB)．MethodsAto30patientstreatedwithmaintenancelow—fluxhemodialysiswithsecondaryhyperparathyroidismwereincludedinthestudy．Allpatientswererandomlydividedintotwogroups：lowfluxhemodialysisgroup(LFHD，n=15)andhighfluxhemodialysiscombinedwithh

5、emoperfusiongroup(HFHD+HP，n=15)．ForLFHDgroup，patientsacceptedLFHDtreatment3timesperweek．ForHFHD+HPgroup，pa·tientsweretreatedwithHFHD+HPonceeverytwoweeks，additionally，patientsinHFHD+HPgroupunderwentLFHDtreatment5timespertwoweeks．Serumcalcium，phosphorus，iPTHandalbumin(ALB)weretestedbetweenthetwogroup

6、satzeroandtwelfthmonthaftertreatment．ResultsThelevelofiPTHdecreasedandthelevelofALBincreasedsignificantlyinHDHP+HPgroupcomparedtotheLFHDgroup(P<0．05)after12monthsoftreatment．ThelevelofiPTHandALBhadnosignificantdifferences(P>0．05)．Aftertreatment，thelevelofP，hs-CRPofHFHD+HPgroupde—creased，therewassig

7、nificantdifferencefP<0．05)．TherewasnosignificantdifferenceofseHlmcalciumbetweentwogroupsf尸=>0．05)．ConclusionHDHPcombinedwithHPtherapymayeffectivelyremovePTHandincreaseALBinmain—tenancehemodialysispatients．[