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目的比较3种血液净化方式对慢性肾功能不全维持性血透患者毒素的清除效果。方法将60例慢性肾功能不全维持性血透患者随机分为血液透析滤过组(HDF)、高通量透析组(HFHD)、低通量透析组(LFHD)3组。观察治疗前、治疗后3个月血红蛋白(Hb)、尿素氮(BUN)、肌酐(Scr)、血钙(Ca2+)、磷(P3-)和甲状旁腺素(PTH)的变化。结果 (1)3种透析方式治疗后BUN、Scr均显著低于治疗前(均P<0.01)。(2)P3-、PTH在HFHD、HDF组治疗后明显低于治疗前;治疗后HDF组血PTH明显低于HFHD组;HFHD、HDF组Hb明显高于治疗前,差异均有统计学意义(均P<0.05)。LFHD组P3-、PTH、Hb治疗前后比较差异无统计学意义(P>0.05)。结论 3种透析方式均能很好地清除BUN、Scr。清除P3-的效果,HDF、HFHD优于LFHD。清除PTH的效果,HDF最佳,HF-HD次之,LFHD效果不明显。HDF、HFHD可以改善尿毒症患者贫血状态。HFHD是一种高效、经济的透析模式,可作为尿毒症患者长期维持血透的方式。
Objective To compare the clearance effect of three kinds of blood purification methods on toxins in patients with chronic renal insufficiency. Methods Sixty patients with chronic renal failure and maintenance hemodialysis were randomly divided into three groups: HDF, HFHD and LFHD. The changes of hemoglobin (Hb), blood urea nitrogen (BUN), creatinine (Scr), calcium (Ca2 +), phosphorus (P3-) and parathyroid hormone (PTH) were observed before treatment and 3 months after treatment. Results (1) The BUN and Scr of three dialysis methods were significantly lower than those before treatment (all P <0.01). (2) P3-, PTH in HFHD, HDF group after treatment was significantly lower than before treatment; after treatment HDF blood PTH was significantly lower than HFHD group; HFHD, HDF group Hb was significantly higher than before treatment, the difference was statistically significant ( All P <0.05). LFHD group P3-, PTH, Hb before and after treatment was no significant difference (P> 0.05). Conclusion All three dialysis methods can remove BUN and Scr well. P3- clear effect, HDF, HFHD better than LFHD. Clear PTH effect, HDF best, followed by HF-HD, LFHD effect is not obvious. HDF, HFHD can improve anemia in patients with uremia. HFHD is an efficient and economical dialysis model that can be used as a long-term hemodialysis way for uremic patients.