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目的比较不同血液净化方式对维持性血液透析患者血钙、血磷、全段甲状旁腺激素及β2微球蛋白的影响。方法选择我院维持性血液透析患者36例随机分为三组:普通血液透析组(HD组)、普通血液透析+血液灌流组(HD+HP组)、普通血液透析+血液透析滤过组(HD+HDF组),比较各组治疗前和治疗16周后血Ca、P、CaxP、β2-MG、ALP及iPTH的变化。结果 HD组治疗前后血Ca、P、CaxP、β2-MG、ALP及iPTH水平无显著变化(P>0.05);HD+HP组和HD+HDF组治疗后与治疗前相比血P、CaxP、β2-MG、ALP及iPTH水平明显下降(P<0.05)。治疗后HD+HP组iPTH较HD+HDF组低(P<0.05);治疗后HD+HDF组β2-MG较HD+HP组低(P<0.05)。结论 HD+HP和HD+HDF治疗能有效改善患者的矿物质和骨代谢紊乱。
Objective To compare the effects of different blood purification methods on serum calcium, phosphorus, total parathyroid hormone and β2 microglobulin in maintenance hemodialysis patients. Methods Thirty-six patients with maintenance hemodialysis in our hospital were randomly divided into three groups: normal hemodialysis group (HD group), ordinary hemodialysis + hemoperfusion group (HD + HP group), ordinary hemodialysis + hemodiafiltration group HD + HDF group). The changes of Ca, P, CaxP, β2-MG, ALP and iPTH were compared before and 16 weeks after treatment. Results There was no significant change in serum Ca, P, CaxP, β2-MG, ALP and iPTH before and after treatment in HD group (P> 0.05) β2-MG, ALP and iPTH levels were significantly decreased (P <0.05). After treatment, iPTH in HD + HP group was lower than that in HD + HDF group (P <0.05). After treatment, β2-MG in HD + HDF group was lower than that in HD + HP group (P <0.05). Conclusion HD + HP and HD + HDF treatment can effectively improve the patients with mineral and bone metabolism disorders.