2017 11 48 6 43 528000 MHD IDH 30 HD HDF HP + HD 10 24 β 2 - β 2 -MG N B NT-proBNP ALB 1HDF + HD HP + HD P < 0. 05 2 HDF β 2 -MG P < 0. 05 24 HP + HD HDF β 2 -MG P < 0. 05 HP + HD P < 0. 05 24 HD NT-proBNP HDF HP + HD NTproBNP P < 0. 05 24 3 ALB 3 ALB P > 0. 05 HDF HP + HD MHD IDH DOI 10. 3969 /j. issn. 1000-8535. 2017. 06. 013 The influence of various blood purification methods on intradialytic hypotension in maintenance dialysis patients LI Zhuanhuan DONG Jiecheng LI Xia ZHANG Keng Chancheng Central Hospital Foshan 528000 China Abstract Objective To explore the efficacy of different blood purification methods on intradialytic hypotension IDH in maintenance hemodialysis MHD patients. Methods Thirty MHD patients with IDH were randomly divided into three groups hemodialysis HD group n = 10 hemodiafiltration HDF group n = 10 hemoperfusion combined with hemodialysis HP + HD group n = 10. The changes of blood pressure in therapy and the frequency of intradialytic hypotension were compared. Before and after the first treatment after 24 weeks of treatment serum blood beta 2-microglobulin β 2 -MG serum NT-proBNP albumin ALB were measured. Results 1Compared with HD group the frequency of intradialytic hypotension was significantly reduced in HDF and HP + HD group P < 0. 05. 2 In HFD group serumβ 2 - MG decreased after the first dialysis session P < 0. 05. After the treatment for 24 weeks serumβ 2 -MG levels decreased in HP + HD and HFD group P < 0. 05 especially in HP + HD group P < 0. 05. Serum NT-proBNP cannot decreased after first dialysis session and after the treatment for 24 weeks in HD group however can decreased in HFD and HP + HD group P < 0. 05. There were no changes of ALB levels between three groups after first dialysis session and after the treatment for 24 weeks P > 0. 05. Conclusion Hemodiafiltration or hemoperfusion associated with hemodilysis can improve the hemodynamic stability in IDH patients it can be used as a long term therapy. Key words Hemodiafiltration Hemoperfusion Intradialytic hypotension IDH MHD probnp β 2 -MG ALB MHD 20% ~ 30% 1 IDH 4 IDH MHD IDH 2-3 IDH IDH IDH IDH IDH NT- 2015 2015256
44 2017 11 48 6 1 1. 1 - / 3 2016 1 2016 6 10 ml / kg h 3 P > 0. 05 IDH 30 1HD 3 / 4 h / 2 1 2 TS-1. 3S 1. 3 4. 0 kpa m 2 200 ~ 300 ml /min 2HDF + HD < 13. 3 kpa < 4. 0 kpa 1 HDF 2 HD 4 h / HDF 1 3 TS-1. 3U 1. 3 m 2 50% 200 ~ 300 ml /min HD HDF + HD HP + HD 10 HD 10 5 5 HA230 2 h 52. 62 ± 12. 68 57. 02 ± 29. 70 3 200 ~ 300 ml /min HD HD 5 0 2 HDF + HD 10 6 4 51. 77 ± 13. 60 56. 08 ± 30. 52 2 5 1 2 HP + HD 10 5 5 52. 58 ± 12. 72 57. 03 ± 30. 15 2 3 5 1 1 5 Ⅲ-Ⅳ NYHA 3 1. 3. 2 24 NT-proB- NP PTH hs-crp β 2 -MG NT- probnp ALB 1. 2 x 珋 ± s SPSS 11. 5 TR-8000YUGA t TR-8000YUGA Na + 140 mmol /L K + 2 mmol /L = 1000 HD HD 3HP + HD 3 1 HD + HP 2 HD 2 h HD 24 1. 3 1. 3. 1 15min 1 h 1 1. 4 LSD Ca 2 + 1. 5 mmol /L Mg 2 + 0. 5 mmol /L HCO - 3 32 ~ χ 2 P < 0. 05 34 mmol /L Gluc 0 mmol /L 2 500 ml /min 4 h 36. 5 2. 1 3 IDH HD 512 71. 1%
2017 11 48 6 45 276 2. 2 3 β 2 -MG NT-proBNP 38. 3% 72 10% HDF + HD 148 20. 6% 58 8. 1% MG P < 0. 05 HD HP + HD β 2-15 2. 1% HP + HD MG 24 HP + HD HDF 156 21. 7% β 2 -MG P < 0. 05 HP + HD 62 8. 6% HD P < 0. 05 16 2. 2% HDF + HD HP + HD IDH HD P < 0. 05 1 1 IDH IDH IDH IDH /% HD 512 208 720 71. 1 HDF + HD 148 572 720 20. 6 ALB HDF β 2-24 HD NT-proBNP HDF HP + HD NT-proBNP P < 0. 05 24 HD P < 0. 05 24 3 ALB 3 ALB P > 0. 05 2 3 HP + HD 156 564 720 21. 7 816 1 344 2 160 37. 8 IDH IDH 2 24 β 2 -MG NT-proBNP ALB x 珔 ± s β 2 -MG / mg L -1 NT-proBNP / pg ml -1 ALB / g L -1 24 24 24 HD 39. 05 ± 9. 80 40. 01 ± 3. 81 38. 89 ± 9. 75 1 739. 46 ± 32. 0 1 598. 4 ± 37. 1 1 815. 40 ± 36. 5 32. 38 ± 4. 37 33. 26 ± 3. 42 32. 75 ± 4. 37 HDF 39. 10 ± 8. 85 18. 15 ± 3. 58 16. 56 ± 3. 85 1 743. 25 ± 28. 2 1 086. 3 ± 42 866. 5 ± 28 32. 12 ± 3. 34 31. 83 ± 3. 26 33. 01 ± 0. 38 HD + HP 38. 91 ± 9. 53 38. 10 ± 8. 22 10. 72 ± 9. 60 1 741. 25 ± 30. 1 1 078. 3 ± 41 878. 3 ± 41 33. 77 ± 2. 81 32. 93 ± 3. 08 33. 66 ± 1. 23 P < 0. 05 HD P < 0. 05 β 2 -MG MHD 5-7 13 β 2 -MG 8 9 14 IDH 15 IDH IDH β 2 -MG IDH NT-proBNP HDF MHD β 2 -MG ALB IDH β IDH 4 2 -MG HD HP + HD β 2 -MG NTproBNP HDF 2 -MG 16 10 β HP HDF HP 24 HP + HD HDF β 2 - HD β 2 -MG 10-12 MG HP + HD HDF HD 17 HP + HD IDH β 2 -MG HP HDF HD + HP β 2 -MG HD P < 0. 05 IDH NT-proBNP 8. 5 KD IDH IDH NT-proBNP β 2 -MG BNP NT-proBNP
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