【摘要】 目的比较3种血液净化方式对维持性血液透析（MHD）患者β₂-微球蛋白（β₂-MG）及钙磷代谢的影响。方法选取MHD患者84例,随机分为低通量血液透析（HD）、低通量HD联合血液透析滤过（HD+HDF）、高通量血液透析（HFHD）3组各28例。HD组给予每周3次低通量HD,HD+HDF组给予每周2次低通量HD+每周1次HD滤过,HFHD组给予每周3次高通量HD。观察治疗前和治疗6个月后患者血钙、血磷、钙磷乘积、全段甲状旁腺激素（iPTH）、β₂-MG的变化。结果 HD组治疗前后血磷、钙磷乘积、iPTH、β₂-MG无显著下降（P>0.05）;HD+HDF、HFHD组治疗前后血磷、钙磷乘积、iPTH、β₂-MG明显下降,分别与HD组比较差异均有统计学意义（P<0.05）;HFHD组较HD+HDF组降磷效果更为显著（P<0.05）。而两组在钙磷乘积、iPTH、β₂-MG水平下降方面差异无统计学意义（P>0.05）。结论 HFHD组与HD+HDF组均可显著清除血磷、降低钙磷乘积、iPTH、β₂-MG水平,有效纠正透析患者的钙磷代谢紊乱。高通量HD操作方便、经济成本较低,是较佳的HD方式。更多还原

【Abstract】 Objective To compare the effects of different hemopurification modes on beta 2-microglobulin(β2-MG)and calcium-phosphorous metabolism with maintenance hemodialysis(HD)patients.Methods Totally 84 maintenance hemodialysis patients were enrolled and randomed into three groups.Group HD was treated by low-flux HD three times a week.Group HD+ hemodialysis filtration(HD+HDF)was treated by low-flux hemodialysis two times a week+ hemodiafiltration one time a week.Group high-flux HD(HFHD)was treated by HFHD three times a week.All patients were followed up for six months.Calcium,phosphorous,Ca×P product,intact parathyroid hormone(iPTH)andβ2-MG were measured before and after six months’ treatment.Results The levels of serum phosphorus,Ca×P product,iPTH andβ2-MG in group HD showed no significant decrease before and after treatment(P >0.05).Serum phosphorus,Ca×P product,iPTH andβ2-MG in group HD+ HDF and HFHD decreased significantly before and after treatment as compared with those in group HD,respectively(P <0.05).Serum phosphorus in group HFHD reduced more than that in group HD+HDF(P <0.05).The levels of Ca×P product,iPTH,β2-MG had no significant difference between HFHD and HD+ HDF group(P >0.05).Conclusion Both HFHD and HD+ HDF could significantly reduce serum phosphorus,Ca×P product,iPTH andβ2-MG,and also effectively improve the calcium and phosphorus metabolism in MHD patients. HFHD might be a better hemopurification mode due to the advantages of convenient operation and low cost.更多还原