何来明

【摘要】 目的：探讨不同血液净化方式对尿毒症患者体内毒素的清除效果。方法：选取60例进行维持性血液净化的尿毒症患者，根据血液净化方式的不同分为两组，各30例。A组采用高通量血液透析治疗，B组采用血液透析滤过治疗。对比两组患者治疗前后各种血清毒素的清除效果。

结果：A组治疗后血磷、甲状旁腺激素水平均显著低于对照组（P<0.05）。两组治疗后血肌酐、血尿酸、血尿素氮、血钾、β2-MG水平比较差异均无统计学意义（P>0.05）。两组Kt/V、nPCR、TACurea水平比较差异无统计学意义（P>0.05）。A组治疗总有效率为96.67%，B组为93.33%，组间比较差异无统计学意义（P>0.05）。结论：血液透析滤过与高通量血液透析治疗尿毒症均能有效清除小分子毒素，但是后者对血磷、甲状旁腺激素的清除效果更显著。

【关键词】 尿毒症； 毒素； 血液净化； 高通量血液透析； 血液透析滤过

doi：10.14033/j.cnki.cfmr.2018.24.002 文献标识码 A 文章编号 1674-6805（2018）24-000-03

Research on the Effect of Different Blood Purification Methods on the Removal of Uremic Toxin/HE Laiming.//Chinese and Foreign Medical Research，2018，16（24）：-6

【Abstract】 Objective：To investigate the effect of different blood purification methods on the elimination of toxins from uremic patients.Method：A total of 60 patients with uremia who underwent maintenance blood purification were divided into two groups （n=30） according to different blood purification methods.Group A was treated with high-flux hemodialysis and group B was treated with hemodiafiltration.Then the serum scavenging effects of various groups of patients before and after treatment were compared.Result：The levels of serum phosphorus and parathyroid hormone in group A were significantly lower than those in the control group （P<0.05）.There were no significant differences in serum creatinine，serum uric acid， blood urea，serum potassium and β2-MG levels between the two groups （P>0.05）.There were no significant differences in Kt/V，nPCR and TACurea levels between the two groups （P>0.05）.The total effective rate of treatment in group A was 96.67%，and that in group B was 93.33%.There was no significant difference between the groups （P>0.05）.Conclusion：Hemodiafiltration and high-flux hemodialysis for the treatment of uremia can effectively eliminate small molecule toxins， but the latter has a more significant effect on the clearance of blood phosphorus and parathyroid hormone.

【Key words】 Uremia； Toxin； Blood purification； High-flux hemodialysis； Hemodiafiltration

First-authors address：Zhangzhou Hospital Affiliated to Fujian Medical University，Zhangzhou 363000，China

尿毒癥是慢性肾衰竭晚期患者表现出的一组临床综合征，其临床表现以代谢紊乱、肾脏功能丧失等为主，严重危害者患者的生命健康[1]。血液净化治疗是目前临床治疗慢性肾衰竭尿毒症的主要手段，其能有效缓解临床症状，延长患者的生存时间。血液透析滤过和高通量血液透析是较为常用的两种血液净化方式，前者主要利用弥散与对流原理进行血液净化，后者主要利用高通量血液透析器进行血液净化[2]。为了解这两种血液净化方式对尿毒症患者血液毒素的清除效果，本文选取了两组采用不同血液净化方式的尿毒症患者进行对照研究，现报道如下。……