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目的探讨血液透析、血液透析滤过及血液灌流三种血液净化方式对慢性肾衰竭患者透析充分性及血清β_2-微球蛋白(β_2-MG)水平的影响。方法选取肾内科透析室行常规透析的75例慢性肾衰竭患者为研究对象,透析时间均在6个月以上。在4周基础透析后,将75例患者随机分为血液透析组、透析滤过组及灌流组,对所有患者进行透析前、首次透析后及透析6个月后体质指数(BMI)、血清血红蛋白、白蛋白、血尿素氮、血肌酐、血尿酸、血清钙、血清磷及β_2-MG水平检测并进行对比分析。结果透析6个月后,透析滤过组及灌流组患者BMI值、血红蛋白及白蛋白水平均高于透析组患者,差异均有统计学意义(P均<0.05)。首次透析后及透析6个月后,透析滤过组及灌流组患者β_2-MG水平均低于透析组患者,差异均有统计学意义(P均<0.05)。结论与传统血液透析方式相比,新型血液净化技术血液透析滤过及血液灌流能更有效的提高慢性肾衰竭患者的透析充分性,其对中分子毒素β_2-MG的清除率更高,有效改善了患者的生命质量。
Objective To investigate the effects of hemodialysis, hemodiafiltration and hemoperfusion on the dialysis adequacy and serum β_2-microglobulin (β_2-MG) levels in patients with chronic renal failure. Methods A total of 75 patients with chronic renal failure undergoing regular dialysis in the Department of Nephrology Dialysis Room were enrolled. The dialysis time was over 6 months. After 4 weeks of basic dialysis, 75 patients were randomly divided into hemodialysis group, dialysis filtration group and perfusion group. All patients before dialysis, after the first dialysis and 6 months after dialysis, the body mass index (BMI), serum hemoglobin , Albumin, blood urea nitrogen, serum creatinine, serum uric acid, serum calcium, serum phosphorus and β_2-MG levels were compared and analyzed. Results After 6 months of dialysis, the BMI, hemoglobin and albumin levels of patients in dialysis group and perfusion group were significantly higher than those in dialysis group (all P <0.05). After the first dialysis and dialysis for 6 months, the levels of β 2-MG in dialysis group and perfusion group were lower than those in dialysis group (all P <0.05). Conclusion Compared with the traditional hemodialysis method, the new blood purification technology hemodiafiltration and hemoperfusion can more effectively improve the dialysis adequacy in patients with chronic renal failure, its clearance rate of mid-molecule toxin β_2-MG is higher and effectively improved The patient’s quality of life.