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目的观察高通量血液透析对维持性血液透析患者小分子溶质、β2-微球蛋白(β2-MG)、血磷清除及血脂的影响。方法将60例行高通量血液透析(HPD)和常规血液透析(CHD)的规律透析患者随机分为HPD组和CHD组,进行维持血液透析1年,每周透析2～3次,每次4.5 h,对两组患者的透析效果进行评价。结果两组患者透析后血尿素氮、血肌酐比较差异无统计学意义,高通量透析组透析后血清β2-MG、血清磷比常规血液透析组明显下降(P<0.05),透析1年后血清β2-MG、血清磷浓度、胆固醇及甘油三酯均明显降低(P<0.01)。结论高通量透析可降低透析患者血清β2-MG、血清磷浓度,改善透析患者的血脂代谢,透析效果优于常规血液透析,透析膜的通量是影响清除血液透析患者血清β2-MG及血清磷浓度的主要因素。
Objective To observe the effect of high-flux hemodialysis on small molecule solutes, β2-microglobulin (β2-MG), serum phosphorus and blood lipid in maintenance hemodialysis patients. Methods Sixty patients undergoing regular dialysis with high-throughput hemodialysis (HPD) and conventional hemodialysis (CHD) were randomly divided into HPD group and CHD group for one year of maintenance hemodialysis and 2 to 3 times a week dialysis 4.5 h, the dialysis effect of two groups of patients were evaluated. Results There was no significant difference in blood urea nitrogen and serum creatinine between the two groups after dialysis. Serum β2-MG and serum phosphorus in high-throughput dialysis group decreased significantly (P <0.05) compared with conventional hemodialysis group. After dialysis for 1 year Serum β2-MG, serum phosphorus concentration, cholesterol and triglyceride were significantly lower (P <0.01). Conclusion High-throughput dialysis can reduce serum β2-MG and serum phosphorus concentration in dialysis patients and improve blood lipid metabolism in dialysis patients. Dialysis effect is superior to conventional hemodialysis. Dialyzed membrane flux is influential in clearance hemodialysis patients serum β2-MG and serum The main factor of phosphorus concentration.