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目的研究高通量血液透析(high flux hemodialysis,HFD)对维持性血液透析(maintain hemodialysis,MHD)患者血清叶酸(Fol)、维生素B12(VitB12)及部分生化指标影响。方法采用前瞻性、自身对照研究,本组44例为常规低通量血液透析(low flux hemodialysis,LFH)患者,转换为HFD治疗1年。单因素方差分析比较透析前、透析后6、12个月透析前Fol、VitB12、Hb、Hct、Cr、BUN、P、Ca、iPTH、ALB、CRP等指标的变化。结果 HFD后6、12个月较LFD时VitB12、Fol有显著升高,差异有统计学意义(P均<0.05);BUN、Cr、Ca等生化指标在转化为HFD后,与LFD时比较,差异无统计学意义(P>0.05);但CRP、iPTH、P、Hb、Hct等指标在两种透析状态下有明显不同,差异有统计学意义(P<0.05)。结论 HFD治疗后Fol、VitB12有增加趋势,进而改善贫血和营养不良,可能会提高血液透析病人的生存质量。
Objective To investigate the effects of high flux hemodialysis (HFD) on serum folic acid (Fol), vitamin B12 (VitB12) and some biochemical parameters in patients with maintenance hemodialysis (MHD). Methods A prospective, self-controlled study was conducted in 44 patients who underwent routine low-flux hemodialysis (LFH) and converted to HFD for 1 year. The changes of FolB, VitB12, Hb, Hct, Cr, BUN, P, Ca, iPTH, ALB, CRP and other indexes before and after dialysis were compared between before and after dialysis by one-way ANOVA. Results Compared with LFD, the levels of VitB12 and Fol at 6 and 12 months after HFD were significantly higher than those at LFD (all P <0.05). After biochemical indexes such as BUN, Cr and Ca were changed to HFD, The difference was not statistically significant (P> 0.05). However, CRP, iPTH, P, Hb, Hct and other indexes were significantly different in the two dialysis conditions, the difference was statistically significant (P <0.05). Conclusion The trend of FolB and VitB12 after HFD treatment is to improve anemia and malnutrition, which may improve the quality of life of hemodialysis patients.