高通量血液透析对尿毒症患者毒副代谢产物及钙磷代谢的影响
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摘要
目的探讨高通量血液透析(HFHD)对尿毒症患者毒副代谢产物及钙磷代谢的影响。方法选取2016年1~12月我院收治的80例尿毒症钙磷代谢异常患者,根据随机数字表法分为对照组(低通量血液透析CHD)和观察组(HFHD),每组各40例,采集血清并检测和比较两组患者透析前后毒副代谢产物及钙磷代谢指标的变化情况。结果与CHD组比较,HFHD组透析后β_2-微球蛋白(β_2-MG)及可溶性转铁蛋白受体(s Tf R)水平均明显降低,差异有统计学意义(P<0.05);与CHD组比较,HFHD组透析后血清磷(P)、甲状旁腺激素(PTH)、碱性磷酸酶(AKP)水平均明显降低,差异有统计学意义(P<0.05)。结论 HFHD能有效清除尿毒症患者毒素分子,改善钙磷代谢异常状态。
Objective To study the improvement role of high flux hemodialysis(HFHD)on the toxic and metabolic products and calcium and phosphorus metabolism for uremic patients.Methods The 80 uremic patients in our hospital during the period from January 2016 to December were randomized into the control group(CHD) and the observation group(HFHD),40 patients in each group.The serum changes of toxic and metabolic product,calcium and phosphorus metabolism on pre-and post-dialysis were detected and compared in two groups.Results Compared with the CHD group,the levels of beta2-microglobulin(β_2-MG) and soluble transferrin receptor(s Tf R) were significantly reduced on post-dialysis in the HFHD group with statistical difference(P<0.05);compared with the CHD group,the levels of serum phosphorus(P),parathyroid hormone(PTH),alkaline phosphatase(AKP) were obviously decreased on post-dialysis in the HFHD group with statistical difference(P<0.05).Conclusion The HFHD can effectively eliminate toxins for uremic patients and improve the abnormal state of calcium and phosphorus metabolism.
Objective To study the improvement role of high flux hemodialysis(HFHD)on the toxic and metabolic products and calcium and phosphorus metabolism for uremic patients.Methods The 80 uremic patients in our hospital during the period from January 2016 to December were randomized into the control group(CHD) and the observation group(HFHD),40 patients in each group.The serum changes of toxic and metabolic product,calcium and phosphorus metabolism on pre-and post-dialysis were detected and compared in two groups.Results Compared with the CHD group,the levels of beta2-microglobulin(β_2-MG) and soluble transferrin receptor(s Tf R) were significantly reduced on post-dialysis in the HFHD group with statistical difference(P<0.05);compared with the CHD group,the levels of serum phosphorus(P),parathyroid hormone(PTH),alkaline phosphatase(AKP) were obviously decreased on post-dialysis in the HFHD group with statistical difference(P<0.05).Conclusion The HFHD can effectively eliminate toxins for uremic patients and improve the abnormal state of calcium and phosphorus metabolism.
引文
[1]曹慧敏,赵冰峰.高通量血液透析及高通量血液透析滤过对骨及矿物质代谢的价值分析[J].中国医药科学,2015,5(12):166-168.
[2]Martin-Rodriguez S,Caballo C,Gutierrez G,et al.TLR4 and NALP3 inflammasome in the development of endothelial dysfunction in uraemia[J].Eur J Clin Invest,2015,45(2):160-169.
[3]伏广浩,刘晓东.低钙透析液联合高通量血液透析对尿毒症患者钙磷及血管钙化的影响[J].现代医药卫生,2015,31(9):1292-1294.
[4]邱炽昌.高通量透析对维持性血液透析患者钙、磷代谢影响分析[J].当代医学,2013,19(34):2-4.
[5]Argyropoulos C,Roumelioti ME,Sattar A,et al.Dialyzer reuse and outcomes of high flux dialysis[J].PLo S One,2015,10(6):e0129575.
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[8]康乐,张晓东,刘晓冬,等.高通量血液透析和常规血液透析对尿毒症患者血脂代谢的影响[J].河北医药,2014,36(11):1690-1691.
[9]罗丹,林彬,张浩,等.高通量血液透析对尿毒症患者血清磷及i PTH清除的疗效观察[J].重庆医学,2016,45(22):3137-3139.
[10]Kim HW,Kim SH,Kim YO,et al.Comparison of the impact of high-flux dialysis on mortality in hemodialysis patients with and without residual renal function[J].PLo S One,2014,9(6):e97184.
[11]孙小伟,李倩.高通量血液透析联合罗盖全对尿毒症患者钙磷代谢紊乱及微炎症状态的影响[J].海南医学,2016,27(20):3331-3334.
[12]严功辉.持续性腹膜透析(CAPD)对尿毒症患者钙磷水平的影响[J].现代诊断与治疗,2013,24(7):1494-1495.
[13]田祥峰.高通量血液透析对老年尿毒症患者60例钙磷代谢异常的临床观察[J].中国中西医结合肾病杂志,2014,15(7):625-626.
[14]金炜,陆晓凤,范为荣,等.不同透析方式对尿毒症患者钙磷代谢影响的临床研究[J].中国现代医生,2017,55(13):30-34.
[15]Reams BD,Dluzniewski PJ,Do TP,et al.Dynamics of cinacalcet use and biochemical control in hemodialysis patients:a retrospective new-user cohort design[J].BMC Nephrology,2015,16(1):175-179.
[2]Martin-Rodriguez S,Caballo C,Gutierrez G,et al.TLR4 and NALP3 inflammasome in the development of endothelial dysfunction in uraemia[J].Eur J Clin Invest,2015,45(2):160-169.
[3]伏广浩,刘晓东.低钙透析液联合高通量血液透析对尿毒症患者钙磷及血管钙化的影响[J].现代医药卫生,2015,31(9):1292-1294.
[4]邱炽昌.高通量透析对维持性血液透析患者钙、磷代谢影响分析[J].当代医学,2013,19(34):2-4.
[5]Argyropoulos C,Roumelioti ME,Sattar A,et al.Dialyzer reuse and outcomes of high flux dialysis[J].PLo S One,2015,10(6):e0129575.
[6]Hoshino J,Yamagata K,Nishi S,et al.Carpal tunnel surgery as proxy for dialysis-related amyloidosis:results from the Japanese society for dialysis therapy[J].Am J Nephrol,2014,39(5):449-458.
[7]Kim HW,Kim SH,Kim YO,et al.The impact of high-flux dialysis on mortality rates in incidenct and prevalent hemodialysis patients[J].Korean J Intern Med,2014,29(6):774-784.
[8]康乐,张晓东,刘晓冬,等.高通量血液透析和常规血液透析对尿毒症患者血脂代谢的影响[J].河北医药,2014,36(11):1690-1691.
[9]罗丹,林彬,张浩,等.高通量血液透析对尿毒症患者血清磷及i PTH清除的疗效观察[J].重庆医学,2016,45(22):3137-3139.
[10]Kim HW,Kim SH,Kim YO,et al.Comparison of the impact of high-flux dialysis on mortality in hemodialysis patients with and without residual renal function[J].PLo S One,2014,9(6):e97184.
[11]孙小伟,李倩.高通量血液透析联合罗盖全对尿毒症患者钙磷代谢紊乱及微炎症状态的影响[J].海南医学,2016,27(20):3331-3334.
[12]严功辉.持续性腹膜透析(CAPD)对尿毒症患者钙磷水平的影响[J].现代诊断与治疗,2013,24(7):1494-1495.
[13]田祥峰.高通量血液透析对老年尿毒症患者60例钙磷代谢异常的临床观察[J].中国中西医结合肾病杂志,2014,15(7):625-626.
[14]金炜,陆晓凤,范为荣,等.不同透析方式对尿毒症患者钙磷代谢影响的临床研究[J].中国现代医生,2017,55(13):30-34.
[15]Reams BD,Dluzniewski PJ,Do TP,et al.Dynamics of cinacalcet use and biochemical control in hemodialysis patients:a retrospective new-user cohort design[J].BMC Nephrology,2015,16(1):175-179.