| 血液透析联合不同时机的血液灌流对尿毒症患者中分子毒素清除效果的探讨 |
| 投稿时间：2017-01-11 修订日期：2017-03-12 点此下载全文 |
| 引用本文：张文阁,李强,刘翠,石坡,张璐,和兴彩,贺艳光,高正玉.血液透析联合不同时机的血液灌流对尿毒症患者中分子毒素清除效果的探讨[J].医学研究杂志,2017,46(11):101-105 |
| DOI：
10.11969/j.issn.1673-548X.2017.11.025 |
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| 基金项目:石家庄市科学技术研究与发展指导计划资助项目（151461093） |
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| 中文摘要:目的 探讨血液透析（HD）联合不同时机的血液灌流（HP）对尿毒症中高分子毒素的清除效果。方法 规律透析尿毒症患者120例，接受血液透析联合不同时机的血液灌流方案治疗。随机分为两组，后置治疗（HD+HP）组和前置治疗（HP+HD）组，治疗频率1次/2周，4小时/次，共2次。采用自身交叉对照研究方法，即后置治疗组第1次组合治疗采用HP后置方案，第2次采用HP前置方案；前置治疗组第1次组合治疗采用HP前置方案，第2次采用HP后置方案。分别留取患者第1次和第2次组合治疗前后血标本，检测血常规、血肌酐（Scr）、尿素氮（BUN）、全段甲状旁腺激素（iPTH）、β2微球蛋白（β2-MG）、血磷（P）等进行分析。结果 两组患者第1次和第2次组合治疗后的血中Scr、BUN、iPTH、β2-MG、P等均显著低于同组治疗前水平（P<0.05）；2组患者采用HP后置方案治疗后，iPTH、β2-MG的下降值均显著大于HP前置方案（P<0.05）。电解质、白蛋白、血红蛋白两种方案差异无统计学意义（P>0.05）。结论 血液透析联合不同时机的血液灌流方案，对尿毒症中高分子毒素的清除效果不同，HP后置方案清除效果最好。 |
| 中文关键词:血液透析 血液灌流 尿毒症 全段甲状旁腺激素 β2微球蛋白 |
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| Hemodialysis Combined Different Molecules in the Timing of Blood Perfusion in Patients with Uremia Toxin Removal Effect is Discussed |
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| Abstract:Objective To discuss the big size molecule toxin removal effect in uremic by hemodialysis (HD) in combination with different occasion of blood perfusion (HP).Methods We take 120 cases uremia patients with regular dialysis and let them accept the therapeutic solution of hemodialysis (HD) in combination with different occasion of blood perfusion (HP) to treat. They are devided into 2 groups which include posttreatment group (HD + HP) and pretreatment group (HP+HD).Treatment frequency:1 time/2 weeks, 4h/time, altogether 2 times.It will be done two times. Using their own cross-control research methods, posttreatment group the first time combination therapy adopt the solution of putting HP postposition and the second time combination thrapy adopt the solution of puttin HP preposition. Pretreatment group the first time combination therapy adopt the solution of putting HP preposition and the second time combination thrapy adopt the solution of putting HP postposition. Blood samples were collected respectively before and after the first and second combination therapy for patients. Routine blooddetection, serum creatinine (Scr), urea nitrogen (BUN), the entire section parathyroid hormone (iPTH), beta 2-microglobulin (β2-MG) and electrolyte are analyzed.Results Two groups after the first and second combination therapy in patients with blood of Scr, BUN, iPTH, β2-MG were significantly lower than group before treatment (P<0.05); After two groups of patients adopt HP postposition solution, the iPTH, β2-MG were significantly greater than the falling value of HP preposition(P<0.05). The electrolyte,albumin and hemoglobin has no statistical significance between two solution (P>0.05).Conclusion There is different effective result for removing the big size molecule toxin in uremic by hemodialysis (HD) in combination with different occasion of blood perfusion (HP). HP postposition solution has the best effect. |
| keywords:Hemodialysis Blood perfusion Uremia Segment parathyroid hormone β2-micro globulin |
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