不同透析方法对血液透析患者血清骨钙素、降钙素、甲状旁腺素及β2-微球蛋白清除的影响

    Effect of different hemodialysis methods on eliminating serum bone gla-protein,calcitionin,parathormone and β2-microglobulin in patients with chronic renal disease

    • 摘要: 目的:探讨采用不同透析方法的血液透析患者血清骨钙素(bone gla-protein,BGP)、降钙素(calcitionin,CT)、甲状旁腺素(parathormone,PTH)及β2-微球蛋白(β2-microglobulin,β2-MG)等的变化规律,比较高通量血液透析(HFHD)和低通量血液透析(LFHD)的疗效。方法:选择30例维持性血液透析(maintenance hemodialysis,MHD)患者,随机分为HFHD组12例和LFHD组18例,连续观察4周。健康成人对照组20例。采用放射免疫法及化学发光法测定血透患者透析前后血清BGP、CT、PTH、β2-MG及透析4周后PTH、β2-MG等水平。结果:两组患者透析前BGP、PTH、β2-MG及P3-均较对照组升高(P<0.01),CT和Ca2+均较对照组降低(P<0.01和P<0.05);LFHD组透析后β2-MG升高(P<0.01),HFHD组降低(P<0.01);BGP、PTH在HFHD组下降更明显(P<0.01),CT在透析前后LFHD组升高,HFHD组降低(P<0.01);透析前、后和透析4周后PTH、β2-MG比较差异均有统计学意义(P<0.01)。HFHD组患者皮肤瘙痒、关节疼痛、抽搐、肌肉痉挛等症状明显缓解。结论:高通量血液透析器可用于普通透析,且透析效果更好,对清除PTH、β2-MG等大分子物质效果显著,优于LFHD。

       

      Abstract: Objective: To explore the change rule of bone gla-protein(BGP),calcitionin(CT),parathormone(PTH) and β2-microglobulin(β2-BG) in serum of 30 patients with chronic renal disease(CRF) by different hemodialysis methods,and compare the therapy effect between low-flux hemodialysis(LFHD) and high-flux hemodialysis(HFHD).Methods: Thirty cases of chronic hemodialysis patients were divided into HFHD group(12 cases) and LFHD group(18 cases),they were followed up for 4 weeks.The variation of serum levels of BGP,CT,PTH,β2-MG in CRF patients were analyzed by radioimmunoassay and chemiluminescent detection methods before and 4 week after hemodialysis.Results: The levels of BGP,PTH,β2-MG and P3- in serum of patients with CRF were higher than those of the controls(P<0.01),but the levels of CT and Ca2+ were lower than that of the controls(P<0.01 and P<0.05) significantly;the level of β2-MG was increased in LFHD group while decrease in HFHD group,and the levels of BGP and PTH were decreased significantly in HFHD group(P<0.01).CT level was increased in LFHD group while decreased in HFHD group(P<0.01).The levels of PTH and β2-MG were markedly reduced when post-dialysis and 4 weeks after dialysis comparing to those of pre-dialysis(P<0.01).The symptoms such as shin pitch,arthralgia,muscle spasm and so on in HFHD group were significantly ameliorated.Conclusions: There was a significant clinical value in testing serum BGP,CT,PTH and β2-MG concentrations for analyzing patients condition,assessing the treatment effect and estimating prognosis of patients with CRF.The efficacy of HFHD is better than that of LFHD.

       

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