高通量血液透析对同型半胱氨酸水平的影响
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摘要
目的研究高通量血透治疗对终末期肾病维持性血透患者高同型半胱氨酸血症的影响。方法将80例规律血透并伴高Hcy终末期肾病患者随机分成两组,分别采用高通量血透及低通量血透治疗6个月后,将低通量组再次分成两组,分别采用高通量血透及低通量血透继续治疗3个月。首次分组后观察治疗前及治疗后3、6个月Hcy、肌酐、尿素氮、磷及PTH水平;二次分组后观察治疗后6个月(从第一次治疗开始,下同)及治疗后9个月上述血生化指标水平。结果首次分组,治疗3个月后,高通量组Hcy、尿素氮及磷、PTH均较低通量组有明显下降,差异具有统计学意义(P<0.05);治疗6个月后,高通量组Hcy、尿素氮、磷及PTH均较低通量组有明显下降,差异具有统计学意义(P<0.05)。二次分组治疗9个月后发现二次高通量组Hcy、磷及PTH均较二次低通量组有明显下降,差异具有统计学意义(P<0.05)。结论高通量血透在清除血同型半胱氨酸方面较低通量血透有优势,其在改善磷代谢紊乱、抑制甲状旁腺功能亢进方面较低通量血液透析亦优势明显,值得进一步推广使用。
引文
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[2]侯建乐,周健美.血液透析患者血浆同型半胱氨酸的研究进展.岭南急诊医学杂志,2010,15(4):354
[3]王晓飞,张利平,丁致民,等.两种透析模式对维持性血液透析患者同型半胱氨酸的影响.中国实验诊断学,2017,21(6):1001
[4]Susantitaphong P,Tiranathanagul K,Katavetin P,et al.Efficacy of convective-controlled double high-flux hemodiafiltration versus on-line hemodiafiltration:1-year prospective study.Blood Purification,2010,29(29):35
[5]Li Y,Wang Y,Lv J,et al.Clinical outcomes for maintenance hemodialysis patients using a high-flux(FX60)dialyzer.Renal Failure,2013,35(9):1240
[6]Susantitaphong P,Tiranathanagul K,Katavetin P,et al.Efficacy of convective-controlled double high-flux
[7]余堂宏,胡宏,陈燕,等.高通量血液透析对尿毒症患者甲状旁腺素和微炎症状态的影响.中国中西医结合肾病杂志,2011,12(7):637
[8]Kim HW,Kim SH,Kim YO,et al.The impact of high-flux dialysis on mortality rates in incident and prevalent hemodialysis patients.Korean J Intern Med,2014,29(6):774
[9]罗海燕,杨丽媛.不同血液净化方式对尿毒症患者生活质量影响的临床研究.中国医疗前沿,2012,7(6):27
[10]尤雪梅,刘蔚玲,狄海莉.叶酸、维生素B-6治疗高同型半胱氨酸血症的疗效观察.中国医院用药评价与分析,2012,12(11):1018
[11]林媚,劳美珍,区景运.不同血液净化方式治疗慢性肾衰竭血液透析患者的疗效观察.当代医学,2013,(13):48
[12]贺晓雯,刘晓渭,徐玉祥,等.血液灌流联合血液透析对慢性肾衰竭患者炎性指标及同型半胱氨酸、甲状旁腺素、β2-微球蛋白的影响研究.中国医药导报,2015,12(6):11
[13]Scazzone C,Bono A,Tornese F,et al.Correlation between low folate levels and hyperhomocysteinemia,but not with vitamin B12 in hypertensive patients.Annals of Clinical&Laboratory Science,2014,44(3):286
[14]Sreckovic B,Sreckovic VD,Soldatovic I,et al.Homocysteine is a marker for metabolic syndrome and atherosclerosis.Diabetes&Metabolic Syndrome,2016,11(3):179
[15]Krieter DH,Hackl A,Rodriguez A,et al.Protein-bound uraemic toxin removal in haemodialysis and post-dilution haemodiafiltration.Nephrology,dialysis,transplantation:official publication of the European Dialysis and Transplant Association-European Renal Association,2010,25(1):212
[16]龚德华,季大玺,陈惠萍,等.高通量维持性血液透析患者甲状旁腺素水平及骨代谢的变化.肾脏病与透析肾移植杂志,2001,10(4):317
[17]蒲正川,冉玉力,廖雪娇,等.高通量血液透析对维持性血液透析患者高同型半胱氨酸血症和左心室结构的影响.临床肾脏病杂志,2017,17(1):24