【摘要】 目的:比较两种灌流器MG150(佛山博新)和HA130(珠海健帆)用于血液灌流联合血液透析(HP+HD)对β2微球蛋白的清除效果。方法:分别选择上海长征医院(中心1)和佛山市第一人民医院(中心2)长期血液透析患者48例和44,随机分为Ⅰ组和Ⅱ组,使用多中心二阶段交叉实验对照观察各组患者治疗前后血液中β2-MG的下降率及两种灌流器对β2-MG的清除率。结果:MG150和HA130联合血液透析(HD)治疗2小时后血β2-MG的下降率分别14.9%为1.7%,差值有统计学意义(F=45.190,P<0.001);治疗开始时MG150和HA130对β2-MG的清除率分别为55.2%、14.5%,差异有统计学意义(F=284.229,P<0.001);治疗2h时MG150和HA130对β2-MG的清除率均为2.7%,差异无统计学意义(F=0,000,P=0.990)。结论:血液灌流联合血液透析可有效清除患者血β2-MG,新型灌流器MG150对β2-MG的清除效果不差于HA130,且治疗开始时的清除率MG150明显优于HA130。更多还原

【Abstract】 Objective:To observe the effect of diffenrent types of hemoperfusion devices combined with hemodialysis(HP+HD) on clearance of β2-microglobulin( β2-MG) in uremic patients. Methods:48 patients in the Changzheng Hosptital Of Shanghai(Center 1) and 44 patients in the First Hospital Of Foshan(Center 2) on maintenance hemodialysis were randomly assigned into two groups. The patients in group Ⅰ received the HA130 plus polysulfone dialyzers(F6; Freseius Medical care,Bad Homburg, Germany) treatment first, and then were treated with MG150 plus F6 after one week conventional dialysis. While patients in group Ⅱ were administered MG150 plus F6 first, and one week later received the HA 130 plus F6 treatment. We prospectively observed the changes of β2-MG in serum before and after each treatment session. Results: The reduction rates ofβ2-MG were 14.9% and 1.7% after 2 hours of MG150 and HA130 combined with HD treatment respectively(F =45.190,P <0.001). And the clearance rate of β2-MG at the beginning were 55.2% and 14.5% in MG150 and HA130 respectively, and the deference was statistical significant(F=284.229,P<0.001). While after 2 hours of treatment, the clearance rate of β2-MG in MG150 and HA130 were all descended to 2.7%. No serious adverse effects were observed.Conclusion: Application of HP+HD can effectively lower serumβ2-MG in maintenance hemodialysis uremic patients. MG150+F6 enhances the clearance of β2-MG in serum more Effectively than HA130 +F6. Clearance rate were both decreaced markedly in two hemoperfusion apparatus after 2 hours treatment.更多还原