不同血液凈化模式對(duì)維持性血液透析患者蛋白結(jié)合類毒素的清除效果
發(fā)布時(shí)間：2018-12-12 01:09
【摘要】：目的:探討不同血液凈化方式對(duì)維持性血液透析(MHD)患者蛋白結(jié)合類毒素清除的效果。方法:選取符合入選標(biāo)準(zhǔn)的MHD患者136例,經(jīng)4周洗脫期,隨機(jī)分成4組:低通量血液透析(LFHD)組、高通量血液透析(HFHD)組,血液透析濾過(HDF)組和血液透析聯(lián)合血液灌流(HD+HP)組,采用高效液相色譜串聯(lián)質(zhì)譜法(HPLC-MS/MS)方法測(cè)定不同血液凈化方法治療前后血清、透析廢液和血液灌流器中馬尿酸(HA)、硫酸對(duì)甲酚(PCS)、硫酸吲哚酚(IS)、3-羧基-4-甲基-5-丙基-2-呋喃丙酸(CMPF)的濃度,觀察對(duì)蛋白結(jié)合類毒素的清除效果。結(jié)果:四種模式皆能有效清除HA,各組之間無差異。對(duì)血清PCS的清除,HDF組和HD+HP組的下降率高于LFHD組(P0.01)和HFHD組(P0.05,P0.01)。對(duì)血清IS的清除,HDF組和HD+HP組高于LFHD組、HFHD組(均P0.05)。對(duì)于血清CMPF的清除,HD+HP組和HDF組明顯高于LFHD組、HFHD組(P0.01),HD+HP組高于HDF組(P0.01),LFHD組與HFHD組相比無差別(P0.05)。結(jié)論:四種方式對(duì)于蛋白結(jié)合力較低的蛋白結(jié)合類毒素清除效率接近于小分子毒素的清除效果;HDF、HD+HP對(duì)中等蛋白結(jié)合力的蛋白結(jié)合類毒素的清除能力優(yōu)于HFHD、LFHD;HD+HP清除高蛋白結(jié)合力的蛋白結(jié)合毒素的能力最佳,HDF次之,LFHD和HFHD幾乎無效。
[Abstract]:Objective: to investigate the effect of different blood purification methods on the clearance of protein-binding toxoid in (MHD) patients with maintenance hemodialysis. Methods: one hundred and thirty-six patients with MHD were randomly divided into four groups: low flux hemodialysis (LFHD) group, high throughput hemodialysis (HFHD) group, low flux hemodialysis (LFHD) group, and high throughput hemodialysis (HFHD) group. High performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS) was used to determine serum before and after treatment in (HDF) group and hemodialysis combined with hemoperfusion (HD HP) group. The concentration of hippuric acid (HA), sulfuric acid p-cresol (PCS), sulfate indole phenol (IS), 3-carboxylic 4-methyl-5-propyl-2-furanolpropionic acid (CMPF) in dialysis waste liquor and hemoperfusion apparatus, To observe the clearance effect of protein-binding toxoid. Results: all the four models could effectively eliminate the difference between the HA, groups. The decrease rate of serum PCS in HDF group and HD HP group was higher than that in LFHD group (P0.01) and HFHD group (P0.05 P0.01). The clearance of serum IS in HDF group and HD HP group was higher than that in LFHD group and HFHD group (P0.05). The clearance of serum CMPF in, HD HP group and HDF group was significantly higher than that in LFHD group and HFHD group (P0.01), HD HP group was higher than HDF group (P0.01), LFHD group and HFHD group had no difference (P0.05). Conclusion: the clearance efficiency of four ways for protein-binding toxoid with low protein binding ability is close to that of small molecular toxin, and that of HDF,HD HP is superior to that of HFHD,LFHD; for medium protein binding ability. HD HP had the best ability to clear the protein-binding toxin with high protein binding ability, followed by HDF, and LFHD and HFHD were almost ineffective.
【作者單位】： 中國(guó)人民解放軍空軍總醫(yī)院腎病科;
【分類號(hào)】：R692
本文編號(hào)：2373595
[Abstract]:Objective: to investigate the effect of different blood purification methods on the clearance of protein-binding toxoid in (MHD) patients with maintenance hemodialysis. Methods: one hundred and thirty-six patients with MHD were randomly divided into four groups: low flux hemodialysis (LFHD) group, high throughput hemodialysis (HFHD) group, low flux hemodialysis (LFHD) group, and high throughput hemodialysis (HFHD) group. High performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS) was used to determine serum before and after treatment in (HDF) group and hemodialysis combined with hemoperfusion (HD HP) group. The concentration of hippuric acid (HA), sulfuric acid p-cresol (PCS), sulfate indole phenol (IS), 3-carboxylic 4-methyl-5-propyl-2-furanolpropionic acid (CMPF) in dialysis waste liquor and hemoperfusion apparatus, To observe the clearance effect of protein-binding toxoid. Results: all the four models could effectively eliminate the difference between the HA, groups. The decrease rate of serum PCS in HDF group and HD HP group was higher than that in LFHD group (P0.01) and HFHD group (P0.05 P0.01). The clearance of serum IS in HDF group and HD HP group was higher than that in LFHD group and HFHD group (P0.05). The clearance of serum CMPF in, HD HP group and HDF group was significantly higher than that in LFHD group and HFHD group (P0.01), HD HP group was higher than HDF group (P0.01), LFHD group and HFHD group had no difference (P0.05). Conclusion: the clearance efficiency of four ways for protein-binding toxoid with low protein binding ability is close to that of small molecular toxin, and that of HDF,HD HP is superior to that of HFHD,LFHD; for medium protein binding ability. HD HP had the best ability to clear the protein-binding toxin with high protein binding ability, followed by HDF, and LFHD and HFHD were almost ineffective.
【作者單位】： 中國(guó)人民解放軍空軍總醫(yī)院腎病科;
【分類號(hào)】：R692
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1 任真真;慢性腎臟病3-5期患者蛋白結(jié)合類尿毒癥毒素的研究[D];河北北方學(xué)院;2015年
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