摘要
目的探讨血液透析(hemodialysis,HD)联合血液灌流(hemoperfusion,HP)的组合型人工肾以及血液透析滤过(hemodiafiltration,HDF)对维持性血液透析患者内皮素(endothelin-1,ET-1)、瘦素(leptin,LEP)及β2-微球蛋白(β2-microglobulin,β2-MG)的清除效果。方法维持性血液透析患者67例,根据治疗方法分为组合型人工肾组34例和HDF组33例,比较2组单次治疗前、后及规律治疗3个月后血ET-1、LEP及β2-MG的清除率。结果 (1)治疗前,HDF组ET-1、LEP及β2-MG分别为(189.11±12.22)ng/L、(22.87±3.17)μg/L、(51.55±4.12)mg/L,组合型人工肾组分别为(194.67±13.55)ng/L、(24.15±3.84)μg/L、(47.54±3.99)mg/L,2组比较差异无统计学意义(P>0.05);(2)单次治疗后,HDF组ET-1、LEP及β2-MG分别为(184.20±11.98)ng/L、(23.15±2.18)μg/L、(28.76±5.45)mg/L,组合型人工肾组分别为(114.24±12.77)ng/L、(25.01±3.32)μg/L、(38.25±3.11)mg/L,组合型人工肾组ET-1以及HDF组β2-MG与治疗前比较明显降低(P<0.05),2组LEP水平与治疗前比较差异无统计学意义(P>0.05);(3)治疗3个月,HDF组ET-1、LEP及β2-MG分别为(154.25±10.09)ng/L、(19.25±3.22)μg/L、(29.34±4.67)mg/L,组合型人工肾组分别为(106.54±20.48)ng/L、(20.17±4.12)μg/L、(30.92±3.75)mg/L,2组ET-1、β2-MG与治疗前比较差异有统计学意义(P<0.05),LEP与治疗前比较有所下降,但差异无统计学意义(P>0.05);(4)单次治疗后及治疗3个月,2组LEP比较差异均无统计学意义(P>0.05);单次治疗后2组ET-1、β2-MG比较差异有统计学意义(P<0.05);治疗3个月,2组ET-1比较差异有统计学意义(P<0.05),但β2-MG比较差异无统计学意义(P>0.05)。结论组合型人工肾以及HDF均可有效清除ET-1、β2-MG,但组合型人工肾单次及短期治疗对ET-1清除效果优于HDF;HDF单次治疗清除β2-MG效果优于组合型人工肾,而短期治疗2种方法清除效果相近;2种技术短期治疗对LEP清除均有一定作用。
Objective To study the effect of combined-type artificial kidney（hemodialysis（HD）＋ hemoperfusion（HP）and hemodiafiltration（HDF）on the clearance of endothelin-1（ET-1）,leptin andβ2-microglobulin（β2-MG）in patients with maintenance hemodialysis（MHD）.Methods Sixty-seven patients with MHD were divided into HD＋ HP group（n=34）and HDF group（n=33）according to different treatment methods.The clearance rates of ET-1,leptin andβ2-MG were compared before and after a single and 3-month regular treatment between two groups.Results ET-1,leptin andβ2-MG were（189.11±12.22）ng/L,（22.87±3.17）μg/L and（51.55±4.12）mg/L in HDF group,showing no significant difference in comparison with those in HD＋ HP group（（194.67±13.55）ng/L,（24.15±3.84）μg/L,（47.54±3.99）mg/L）before treatment（P0.05）.ET-1,leptin andβ2-MG after a single treatment were（184.20±11.98）ng/L,（23.15±2.18）μg/L and（28.76±5.45）mg/L in HDF group,and（114.24±12.77）ng/L,（25.01±3.32）μg/L and（38.25±3.11）mg/L in HD＋HP group,ET-1in HD＋HP group andβ2-MG in HDF group were significantly lower than those before treatment（P0.05）,and there was no significant difference in leptin level in both groups after treatment in comparison with those before treatment（P0.05）.ET-1,leptin andβ2-MG after 3-month treatment were（154.25±10.09）ng/L,（19.25±3.22）μg/L and（29.34±4.67）mg/L in HDF group,and were（106.54±20.48）ng/L,（20.17±4.12）μg/L and（30.92±3.75）mg/L in HD＋ HP group,showing significant differences in ET-1andβ2-MG in both groups in comparison with before treatment（P0.05）,and no significant difference in leptin although it decreased after 3-month treatment（P0.05）.There was no significant difference in leptin between two groups after single and 3-month treatment（P0.05）.There were significant differences in ET-1andβ2-MG after single treatment between two groups（P0.05）.There was a significant difference in ET-1（P0.05）and no significant difference inβ2-MG（P0.05）after 3-month treatment between two groups.Conclusion Both HD＋HP and HDF can effectively clear ET-1andβ2-MG.HD＋HP is superior to HDF in clearing ET-1after single treatment in short term,HDF is superior to HD＋HP in clearingβ2-MG by a single treatment,and there is no significant difference in the short-term effect between two methods.Both HD＋HP and HDF can clear leptin in a short term.
出处
《中华实用诊断与治疗杂志》
2015年第5期468-470,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
河南省医学科技攻关计划项目(201004022)
关键词
终末期肾脏病
组合型人工肾
血液透析滤过
内皮素
瘦素
Β2-微球蛋白
End-stage renal disease combined-type artificial kidney hemodiafiltration endothelin-1 leptin β2-microglobulin
