中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (12): 2261-2264.doi: 10.3969/j.issn.1673-8225.2011.12.042

• 生物材料临床实践 clinical practice of biomaterials • 上一篇    下一篇

吸附式透析清除尿毒症中分子物质

郭爱华，孟建中，李丹丹，刘文渊，王素霞，高  飞，景  颖，贾凤玉，葛彦明   

  1. 解放军济南军区总医院血液净化科，山东省济南市  250031
  • 收稿日期:2010-10-13 修回日期:2010-11-25 出版日期:2011-03-19 发布日期:2011-03-19
  • 通讯作者: 孟建中，教授，博士后导师，解放军济南军区总医院血液净化科，山东省济南市 250031
  • 作者简介:郭爱华★，女，1981年生，山东省滕州市人，2010年泰山医学院毕业，硕士，主治医师，主要从事肾脏病临床与基础研究工作。
  • 基金资助:

    济南军区“十一五”重大计划课题：体外血液净化疗法救治“生物活化物质损伤综合征”的研究(J115N002)。

Adsorptive dialysis for cleaning uremic middle molecular substances

Guo Ai-hua, Meng Jian-zhong, Li Dan-dan, Liu Wen-yuan, Wang Su-xia, Gao Fei, Jing Ying,
Jia Feng-yu, Ge Yan-ming   

  1. Department of Blood Purification, General Hospital of Jinan Military Command of Chinese PLA, Jinan  250031, Shandong Province, China
  • Received:2010-10-13 Revised:2010-11-25 Online:2011-03-19 Published:2011-03-19
  • Contact: Meng Jian-zhong, Professor, Doctoral supervisor, Department of Blood Purification, General Hospital of Jinan Military Command of Chinese PLA, Jinan 250031, Shandong Province, China mjz90@yahoo.com.cn
  • About author:Guo Ai-hua★, Master, Attending physician, Department of Blood Purification, General Hospital of Jinan Military Command of Chinese PLA, Jinan 250031, Shandong Province, China
  • Supported by:

    “Eleventh Five-Year” Plan for Jinan Military Area Command of Chinese PLA, No. J115N002*

PDF

584

被引次数

12

摘要：

背景: 常规血液透析主要清除尿素氮、肌酐等小分子质量毒素，但对中分子物质清除很少。随着透析时间的延长，大量中分子物质在患者体内蓄积，从而引发一系列并发症。
目的：比较吸附式透析(血液灌流联合血液透析)与常规血液透析对尿毒症患者血液中分子物质的清除作用。
方法：维持性血液透析患者随机分为吸附式透析组及常规血液透析组各30例。吸附式透析组先将血液灌流器与透析器串联实施吸附透析(血液灌流器安置在透析器之前)，治疗120 min后取下灌流器，继续实施血液透析120 min，常规血液透析组实施常规血液透析240 min。治疗前后检测肝功、肾功、血清电解质、血细胞数及中分子毒素浓度，并观察临床症状的变化。
结果与结论：吸附性透析能显著清除患者体内的中分子物质，单次使用治疗120 min后中分子物质浓度显著下降，与单纯血液透析组相比差异有显著性意义(P < 0.05)。吸附式透析组治疗后血小板水平均较治疗前明显降低(P < 0.05)，并与单纯透析组相比有显著性意义(P < 0.05)。两组肝功、肾功指标、电解质浓度差异无显著性意义。吸附式透析组皮肤瘙痒、睡眠障碍及肌肉疼痛等症状有不同程度改善。

关键词: 吸附式透析, 中分子毒素, 透析模式, 并发症, 生物材料

Abstract:

BACKGROUND: Conventional hemodialysis mainly for cleaning uremic micro molecule substance, such as urea nitrogen or creatinine; however, few hemodialyses can clean uremic middle molecule substances (MMS). With prolonged dialysis duration, MMS accumulates in vivo and induces a series of complications.  
OBJECTIVE: To compare the efficiency of adsorptive dialysis (hemoperfusion unites hemodialysis) and conventional hemodialysis in cleaning uremic MMS. 
METHODS: Totally 60 maintenance hemodialysis patients were averagely divided into the adsorptive dialysis group and conventional hemodialysis group. First of all, hemoperfusion apparatus and dialyser were connected in series to take the adsorptive dialysis in the adsorptive dialysis group (hemoperfusion apparatus were equipped before dialyser). 120 minutes later, the hemoperfusion apparatus was toke off and continues to hemodialysis for 120 minutes. Duration of conventional hemodialysis was 240 minutes. Changes in clinical symptoms and levels of liver function, kidney function, serum electrolytes, hemocytes and uremic MMS were observed prior to and after treatment. 
RESULTS AND CONCLUSION: Adsorptive dialysis could remove the MMS notably. Compared with the conventional hemodialysis group, a single 120 minutes treatment could decrease MMS significantly (P < 0.05). The platelet levels were obviously decreased in the adsorptive dialysis group after treatment (P < 0.05), which were significantly different from the conventional hemodialysis group (P < 0.05). There was no significant difference in liver function, kidney function or serum electrolytes concentration. But related symptoms, such as the skin itch, sleep disorders and myalgia, were relieved more or less.

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