内科

目的比较联机血液透析滤过（OL-HDF）与常规血液透析（RHD）对维持性血液透析（MHD）患者的临床疗效。方法将入选的60例MHD患者按随机排列表法分为两组，HDF组30例行后稀释法OL-HDF，HD组30例行RHD治疗。观察治疗前后及组间并发症发生情况，以及甲状旁腺素（PTH）、β2-微球蛋白（β2-MG）、超敏C反应蛋白（hs-CRP）、Kt/V 值的变化。结果OL-HDF可减少MHD患者的顽固性皮肤瘙痒、周围神经病变、慢性骨痛等并发症；治疗6个月后HDF组血清PTH、β2-MG、hs-CRP水平较HD组显著降低，而Kt/V值变化差异无统计学意义。结论OL-HDF能更好地清除尿毒症毒素，预防和减少透析相关并发症的发生，明显改善MHD患者微炎症状态，提高患者治疗效果及生活质量。

ObjectiveTo compare the efficacy of on-line hemodiafiltration (OL-HDF) and regular hemodialysis (RHD) on maintenance hemodialysis (MHD) patients.Methods60 MHD patients were selected randomly,30 patients among them received OL-HDF treatment and the other half of the patients were under RHD treatment.The clinic symptoms were observed and compared before and after treatment,as well as the concentration of parathyroid hormone (PTH),β2-microglobulin (β2-MG),high sensitivity C-reactive protein (hs-CRP) in serum,and Kt/V.ResultsOL-HDF can reduce complications in MHD patients,such as obstinate pruritus,peripheral neuropathy,chronic ostealgia,and so on;the concentration of PTH,β2-MG,and hs-CRP of patients were reduced remarkably post 6 months of treatment.These observations were significant difference between the two groups except Kt/V.ConclusionsOL-HDF can remove the uremic toxins from blood more effectively,prevent and reduce the rate of hemodialysis-related complications,improve the micro-inflammatory status and clinical symptoms as well as the quality of MHD patients′ lives.

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