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目的:比较血液灌流(HP)联合血液透析(HD)与普通HD治疗尿毒症的效果。方法:将58例维持性HD患者分成两组,对照组28例,单独HD治疗;治疗组30例,在HD基础上联合HP治疗。观察临床症状改善情况,治疗前、治疗后1个月检测血液尿素氮(BUN)、肌酐(Cr)、β2微球蛋白(β2-MG)、甲状旁腺激素(PTH)、电解质、白蛋白、球蛋白、血常规。结果:治疗组临床症状的改善优于对照组(P﹤0.01或0.05);治疗组β2-MG、PTH较治疗前明显降低,Hb较治疗前升高,对照组β2-MG、PTH、Hb无明显变化,组间比较差异具有统计学意义(P﹤0.01或0.05);两种方法在清除BUN、Cr方面无明显差异(P﹥0.05);两组治疗前后白蛋白、球蛋白、白细胞、血小板、电解质无明显变化。结论:HP联合HD治疗能更好地清除体内β2-MG、PTH等中分子物质,临床症状改善效果优于HD。
Objective: To compare the effect of hemoperfusion (HP) with hemodialysis (HD) and ordinary HD in the treatment of uremia. Methods: 58 patients with maintenance HD were divided into two groups, the control group of 28 cases, HD alone; the treatment group of 30 cases, combined with HD on the basis of HP treatment. The changes of clinical symptoms were observed. Before treatment, blood urea nitrogen (BUN), creatinine (Cr), β2-MG, PTH, electrolytes, albumin, Globin, blood routine. Results: The improvement of clinical symptoms in the treatment group was better than that in the control group (P <0.01 or 0.05). The β2-MG and PTH in the treatment group were significantly lower than those before treatment, while the levels of Hb in the treatment group were significantly higher than those in the control group (P <0.01 or 0.05). There was no significant difference between the two methods in the clearance of BUN and Cr (P> 0.05). The levels of albumin, globulin, white blood cells and platelets in the two groups before and after treatment were significantly different , Electrolyte no significant change. Conclusion: HP combined with HD treatment can better remove β2-MG, PTH and other molecular substances in vivo, and the improvement of clinical symptoms is better than that of HD.