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目的:探讨残余肾功能(RRF)对维持性血液透析患者的影响。方法:将2013年1月至2014年9月广州医科大学附属第二医院血液净化中心收治的66例已行血液透析3个月以上的患者进行血红蛋白、血钙、血磷、血甲状旁腺激素(i PTH)、血白蛋白的检测,将所得数据分别与残余肾小球滤过率(GFR)、单室尿素清除率(sp Kt/V)进行相关性分析。同时根据尿量将患者分为两组,尿量>100 m L/24 h的患者有RRF组,尿量<100 m L/24 h的为无RRF组,比较两组上述指标的差异。结果:66例维持性血透患者的血红蛋白、白蛋白、i PTH与GFR水平有相关(P<0.05),血磷与GFR有显著相关(P<0.01),血钙与GFR无相关(P>0.05);所有指标与sp Kt/V无统计学相关(P>0.05)。与无RRF组比较,有RRF组在血磷、i PTH的水平较低,二项指标差异有统计学意义(P<0.05),而在血钙和血白蛋白、血红蛋白无明显差异(P>0.05)。结论:RRF在治疗维持性血液透析患者贫血、降低血磷及i PTH有重要作用。
Objective: To investigate the effect of residual renal function (RRF) on maintenance hemodialysis patients. Methods: From January 2013 to September 2014, 66 cases of hemodialysis patients who had undergone hemodialysis for more than 3 months were enrolled in the Blood Purification Center of the Second Affiliated Hospital of Guangzhou Medical University. Hemoglobin, serum calcium, phosphorus, parathyroid hormone (i PTH), serum albumin, and the correlation between the data and residual glomerular filtration rate (GFR) and single compartment urea clearance (sp Kt / V) were analyzed. At the same time, patients were divided into two groups based on urine output, RRF group with urine output> 100 m L / 24 h and no RRF group with urine output <100 m L / 24 h. Results: There was a significant correlation between hemoglobin, albumin, i PTH and GFR in 66 patients with maintenance hemodialysis (P <0.05), but there was a significant correlation between serum phosphate and GFR (P <0.01) 0.05). All the indexes had no significant correlation with sp Kt / V (P> 0.05). Compared with no RRF group, there was a lower level of serum phosphorus and i PTH in RRF group (P <0.05), but no significant difference in blood calcium, serum albumin and hemoglobin (P> 0.05). Conclusions: RRF plays an important role in the treatment of anemia, hypophosphatemia and i PTH in maintenance hemodialysis patients.