联机血液透析滤过清除瘦素及β2微球蛋白的疗效分析

目的观察联机血液透析滤过（HDF）对慢性肾衰竭患者瘦素（leptin）和胆微球蛋白（β2-MG）的清除效果。方法将57例行维持性血液透析治疗的慢性肾衰竭患者随机分成Ⅰ、Ⅱ和Ⅲ组，各19例，分别接受血液透析（HD）、HDF和联机HDF治疗。采用放射免疫分析法检测血清leptin和β2-MG的浓度，比较各组治疗前后血清leptin及β2-MG浓度及各组单次治疗对leptin及β2-MG的清除效果。结果①与治疗前相比，Ⅰ组患者治疗后血清leptin及β2-MG浓度差异无统计学意义（P〉0．05），Ⅱ组和Ⅲ组治疗后血清leptin和β2-MG浓度均降低，差异均有统计学意义（P〈0．05）；②与Ⅰ组相比，Ⅱ组和Ⅲ组leptin和β2-MG浓度的下降率明显增加，差异有统计学意义（P〈0．05），但Ⅱ组和Ⅲ组差异无统计学意义（P〉0．05）。结论联机HDF能够有效清除大分子毒素，是一种安全、快捷、高效的血液透析方式．

The clinical therapeutic effectiveness of the clearance for serum leptin and β2-microglobulin with the blood purification method of on-line hemodiafiltration

Objective To investigate the clearance effect of the blood purification method of on-line hemodiafiltration for serum leptin and β2-microglobulin（β2-MG） in the patients with chronic renal failure. Methods Fifty-seven maintenance herr-ialysis patients were randomly divided into hemodialysis （HD） group （group Ⅰ）, hemodialysis filtration （HDF） group （group Ⅱ）, and on-line hemodialysis filtration group （group Ⅲ）. Each group had 19 patients. The serum concentrations of leptin and β2-MG were determined by radioimmunoassay,and compared before and after treatment. The single clearance effect of leptin and β2-MG were compared among the three groups. Results ①After treatment, the serum concentrations of leptin and β2-MG were significantly reduced in the group Ⅱ and group Ⅲ （P〈0. 05）, while there was no significant difference in the group I（P〉0. 05） ;②As compared with the group Ⅰ,the decrease rate of leptin and β2-MG in group Ⅱ and group Ⅲ was increased （P〈0. 05） ,but there was no significant difference between Ⅱ group group Ⅲ（P〉0. 05）. Conclusions On-line HDF is one of the safe,efficient and convenient blood purification methods which can eliminate macromolecule toxins.