Abstract：Objective: To explore the clinical effects of hemodialysis (HD) and high-flux hemodialysis (HFHD) in the treatment of uremia with hyperphosphatemia. Methods: The clinical data of 126 patients with uremia complicated with hyperphosphatemia were retrospectively analyzed. The patients with HFHD for blood purification therapy were included in observation group (n=74), and the patients with HD were included in control group (n=52). The serotoxin indexes [creatinine (SCr), urea nitrogen (BUN), parathyroid hormone (PTH), β2-microglobulin (β2-MG)], calcium-phosphorus metabolism indicators (blood calcium, blood phosphorus, calcium-phosphorus product) and nutritional status indicators [serum albumin (ALB), serum prealbumin (p-ALB), upper arm muscle circumference (AMC)] were compared between the two groups before treatment and after 3 months of treatment. Results: After 3 months of treatment, the serum levels of SCr and BUN in the two groups were significantly decreased compared with those before treatment while the serum calcium level was significantly increased compared with that before treatment (P<0.05), but there were no statistically significant differences between the groups at the same time (P>0.05). The levels of serum PTH, β2-MG and blood phosphorus and calcium-phosphorus product in the two groups were significantly lower than those before treatment, and the levels in observation group were significantly lower than those in control group at the same time (P<0.05). The levels of ALB, p-ALB and AMC in the two groups were significantly increased compared with those before treatment, and the levels in observation group were significantly higher than those in control group at the same time (P<0.05). Conclusions: Compared with HD, HFHD for patients with uremia and hyperphosphatemia can effectively remove PTH in the body, more actively correct calcium-phosphorus metabolism, improve the body nutritional status, and benefit its prognosis and rehabilitation.
常文静, 次仁央金. 血液透析与高通量血液透析对尿毒症合并高磷血症患者血清PTH机体营养状况的影响[J]. 河北医学, 2019, 25(9): 1556-1559.
CHANG Wenjing, et al. Effects of Hemodialysis and High-flux Hemodialysis on Serum PTH and Body Nutritional Status of Patients with Uremia Complicated with Hyperphosphatemia. HeBei Med, 2019, 25(9): 1556-1559.
[1] 王旭方,陈继红,江燕,等.慢性肾脏病流行病合作工作组方程在慢性肾脏病2~3期老年患者肾功能评估中的意义[J].安徽医药,2018,22(6):1046~1050. [2] 徐梦露,徐旭东.维持性血透患者高磷血症的现状与治疗进展[J].中国中西医结合肾病杂志,2016,17(6):557~559. [3] 罗佳佳,褚以德,李瑜琳.慢性肾脏病微炎症状态及其与营养不良关系的研究进展[J].山东医药,2016,56(14):107~109. [4] 班遵浦,罗国鸿,陈彤.高通量透析的效果及对患者生存率的影响[J].中国现代医学杂志,2017,27(11):125~128. [5] Inker LA,Astor BC,Fox CH,et al.KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD[J].American Journal of Kidney Diseases,2014,63(5):713~735. [6] 邱丹丹,蒋松.慢性肾脏病甲状旁腺激素代谢异常的研究进展[J].肾脏病与透析肾移植杂志,2017,26(2):174~178. [7] 黄捷波.不同血液净化方式对慢性肾衰竭患者透析充分性及血清β_2-MG的影响[J].中国临床研究,2016,29(05):645~647. [8] 杨静,蒋文勇,于黔,等.高通量血液透析对糖尿病肾病维持性血液透析患者氧化应激和微炎症状态的影响[J].广东医学,2016,37(18):2784~2786. [9] 范一超,顾自强,薛应斌,等.超纯透析联合高通量透析对血液透析患者微炎症状态及生存质量的影响[J].重庆医学,2016,45(25):3538~3540. [10] 王耿.高通量透析对尿毒症患者的疗效观察及对患者血脂代谢的影响[J].河北医学,2015,21(3):422~425
2019, Vol. 25 
冀公网安备13080202000677号