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目的探讨不同血液净化方法对尿毒症继发甲状旁腺功能亢进的治疗效果。方法选择岑溪市人民医院2013年1月至2014年11月确诊为尿毒症并继发甲状旁腺功能亢进的患者126例,分为三组,每组42例,分别采用血液透析治疗、血液灌流结合血液透析治疗、血液透析滤过治疗,每组42例,比较三组患者治疗前及治疗后6个月钙磷水平及甲状旁腺激素及β2微球蛋白清除效果,以了解3种不同血液净化方法的治疗效果。结果治疗结束后6个月血液灌流结合血液透析治疗、血液透析滤过组的甲状旁腺激素及β2微球蛋白与治疗前比较明显下降(P<0.05),血液透析治疗组的甲状旁腺激素及β2微球蛋白与治疗前相比未见明显降低(P>0.05);治疗后6个月三组血钙水平未见明显变化(P>0.05),血液灌流结合血液透析组的血磷水平明显下降(P<0.05),其他两组未见明显下降(P>0.05)。结论血液灌流结合血液透析治疗、血液透析滤过能够提高尿毒症继发甲状旁腺功能亢进患者的甲状旁腺激素及β2微球蛋白的清除率,血液灌流结合血液透析组还具有调节患者血磷的功能。
Objective To investigate the therapeutic effect of different blood purification methods on secondary hyperparathyroidism of uremia. Methods A total of 126 patients diagnosed as uremia and secondary hyperparathyroidism from January 2013 to November 2014 in Cenxi People’s Hospital were divided into three groups with 42 cases in each group. They were treated with hemodialysis, hemoperfusion Combined with hemodialysis treatment, hemodiafiltration treatment, 42 cases in each group, before and after treatment compared six groups of calcium and phosphorus levels and parathyroid hormone and β2 microglobulin clearance to understand the three different blood Purification method of treatment. Results After six months of treatment, hemoperfusion combined with hemodialysis resulted in a significant decrease of parathyroid hormone and β2 microglobulin in hemodiafiltration group (P <0.05), parathyroid hormone in hemodialysis group (P> 0.05). There was no significant change in serum calcium levels in the three groups at 6 months after treatment (P> 0.05). The levels of serum phosphorus in hemodialysis group and hemodialysis group (P <0.05), but no significant decrease in the other two groups (P> 0.05). Conclusion Hemoperfusion combined with hemodialysis treatment, hemodiafiltration can improve the clearance of parathyroid hormone and β2 microglobulin in patients with secondary hyperparathyroidism of uremia, hemoperfusion combined with hemodialysis group also has the ability to regulate patients with phosphorus Function