【摘要】 目的探讨高通量血液透析对维持性血液透析尿毒症患者血清瘦素的清除效果。方法40例维持性血液透析患者,随机分成高通量血液透析组(n=20)和常规血液透析组(n=20),于透析前、透析结束时检测血清瘦素、尿素氮(BUN)、肌酐(Cr),进行统计学分析,并与10例健康人的血清瘦素对照。结果透析前,两组间血清瘦素、BUN和Cr差异无统计学意义;尿毒症患者的血清瘦素显著高于健康对照者(P<0.001)。与透析前比较,高通量透析组血清瘦素、BUN和Cr浓度显著降低(P<0.001);常规血液透析组只有血清BUN和Cr浓度显著降低(P<0.001),而血清瘦素差异无统计学意义(P>0.05)。高通量透析组血清瘦素浓度下降与常规血液透析组相比差异有统计学意义(P<0.001),但两组的血清BUN和Cr下降差异无统计学意义(P>0.05)。结论尿毒症患者血清瘦素显著高于健康者,高通量血液透析能有效清除血清瘦素,同时对小分子物质的清除与常规血液透析具有同样的效果,常规血液透析对血清瘦素无清除作用。更多还原

【Abstract】 Objective To investigate the efficacy of high permeability dialysis(HPD) on the removal of serum leptin in patient streated with maintenance dialysis.Methods 40 maintenance hemodialysis patients were randomly divided into HPD group(n=20) and conventional hemodialysis(CHD) group (n=20).HPD and CHD were done 4.5 hours each time and twice a week. Their levels of serum blood ureanitrogen(BUN),creatinine(Cr),and serum leptin were detected before and after hemodialysis.The serum leptin of 10 health persons was detected.The results were statistically analyzed.Results There was no significant difference in the pre-dialysis levels of serum leptin,BUN and Cr between two groups.The levels of serum leptin in patients with uraemia were significantly higher than those in health collators(P<0.001).In patients with HPD,the post-dialysis levels of serum leptin ,BUN and Cr were significantly lower than those pre-dialysis(P<0.001).However, in patients with CHD, only the post-dialysis levels of serum BUN and Cr were significantly lower than those pre-dialysis(P<0.001) .No significant difference was found in the levels of serum leptin before and after treatment in CHD group(P>0.05). On the other hand,the levels of serum leptin were significantly lower in HPD group than those in CHD group after treatment(P<0.001) But,there was no significant difference in the post-dialysis levels of serum BUN and Cr between two groups (P>0.05).Conclusion The serum leptin in patients with uraemia is significantly higher than that in health collators. HPD can effectively eliminate serum leptin. And the removal efficacy of small molecular solutes in HPD is similar to that in CHD.Furthermore,CHD has no effect in eliminating serum leptin.更多还原