A controlled clinical trial of efficacy of HHD and HDF + HD
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摘要: 目的 探讨高通量血液透析(HHD)和血液透析滤过+普通透析(HDF+HD)在慢性肾功能衰竭尿毒症患者中的应用效果。 方法 选择2013年8月—2014年12月间在温州康宁医院进行透析治疗的62例慢性肾衰竭尿毒症患者做观察组,并选择同期在合作单位进行透析治疗的74例慢性肾衰竭尿毒症患者作为对照组。观察组患者每周给予3次高通量透析,对照组患者每周给予1次血液透析滤过和2次普通血液透析。透析前、后,对2组患者血清中小分子毒素(血尿素、血肌酐、血尿酸、血钾、血磷)、中分子毒素(甲状旁腺激素)、大分子毒素(血β2微球蛋白、半胱氨酸蛋白酶抑制剂C)水平进行检测。透析后,对2组尿素透析充分性指标(尿素清除指数、标准蛋白质分解代谢率、时间平均尿素浓度)进行检测。通过2组数据的对比分析,对HHD和HDF+HD透析方法的临床效果进行比较。 结果 2组患者透析后,各毒素的水平均出现显著性降低(P<0.05);且观察组血磷、甲状旁腺激素、半胱氨酸蛋白酶抑制剂C水平显著性低于对照组(P<0.05)。2组尿素清除指数、标准蛋白质分解代谢率、时间平均尿素浓度比较,差异无统计学意义(P>0.05)。 结论 相对于HDF+HD,HHD对中、大分子毒素的清除效果更好。Abstract: Objective To compare the clinical efficacy of high flux hemodialysis(HHD) and hemodiafiltration(HDF)+hemodialysis(HD) in the treatment of chronic renal failure with uremia. Methods A total of 62 cases of chronic renal failure with uremiatreated with hemodialysis from August 2013 to December 2014 in our hospital were enrolled into the observation group,and 74 patients treated with hemodialysis in cooperative hospital in the same period were enrolledinto control group.The patients in the observation group were given high flux hemodialysis(3 times each week);and the patients in the control group were given hemodiafiltration(once each week) and hemodialysis(twice each week).Before and after the hemodialysis,the small-molecular substances(blood urea,creatinine,uric acid,potassium,phosphorus),middle-molecular substances(parathyroid hormone),and large-molecular substances(blood β2-microglobulin,cysteine protease inhibitors C) levels of two groups were observed.And after the hemodialysis,the urea dialysis adequacy indicators(urea clearance index,standard protein catabolic rate,time-averaged urea concentration) of both groups were compared.The clinical efficacies of HHD and HDF+HD were compared between the two groups. Results After the dialysis,the levels of all observed toxinsin both groups were significantly reduced(P<0.05);and levels of serum phosphorus,parathyroid hormone,cystatin C in the observation group were significantly lower than those in the control group(P<0.05).The differences inurea clearance index,standard protein catabolic rate,time-averaged urea concentration were not significant between the two groups(P>0.05). Conclusion As compared with HDF+HD,HHD has better efficacy on removing the middle- and large-molecular toxins.
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Key words:
- Chronic renal failure /
- Uremia /
- High-flux hemodialysis /
- Hemodiafiltration
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