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目的为了评估和对比血液透析(HD)、血液透析+血液灌流(HD+HP)、血液透析滤过(HDF)三种血液净化方式对维持性血透患者血清甲状旁腺激素(PTH)的清除效果及影响。方法60例血透患者随机分成三组:HD组20例,采用低通量聚砜膜透析器F6,血流量250~300 m l/m in。HD+HP组20例,HA型树脂灌流器串联在F6透析器前使用,血流量200~250 m l/m in。HDF组20例,用高通量聚砜膜F60滤过器,血流量200~250 m l/m in。分别测定各组治疗前后PTH水平,计算其下降率和P值。结果三种治疗方式均可使PTH降低,其中HDF组PTH下降率为58.5%(P<0.05),HD+HP组PTH下降率为49.2%(P<0.05),HD组PTH下降率为13.3%(P>0.05)。结论HD+HP和HDF治疗能明显降低患者的PTH,很好地改善血透患者的继发性甲状旁腺功能亢进症状,而HD治疗则不能有效清除PTH。
Objective To evaluate and compare the clearance of serum parathyroid hormone (PTH) in maintenance hemodialysis patients by three blood purification methods: hemodialysis (HD), hemodialysis + hemoperfusion (HD + HP) and hemodiafiltration (HDF) Effect and impact. Methods Sixty hemodialysis patients were randomly divided into three groups: HD group, 20 cases, low-dose polysulfone membrane dialyzer F6, blood flow of 250-300 ml / min. HD + HP group, 20 cases, HA-type resin perfusion device in series before use F6 dialyzer, blood flow 200 ~ 250 m l / m in. HDF group of 20 cases, with high-throughput polysulfone membrane F60 filter, blood flow of 200 ~ 250 m l / m in. The levels of PTH in each group before and after treatment were measured, and the rate of decrease and P value were calculated. Results The decrease of PTH in HDF group was 58.5% (P <0.05), PTH in HD + HP group was 49.2% (P <0.05), PTH in HD group was 13.3% (P> 0.05). Conclusion HD + HP and HDF treatment can significantly reduce the patient’s PTH, and improve the secondary hyperparathyroidism in hemodialysis patients, HD treatment can not effectively clear PTH.