目的:比较不同血液净化方式对血清β2微球蛋白清除的差异。方法:对2007年1-5月在本中心接受血液净化治疗的尿毒症患者进行血清β2微球蛋白筛查,〉5 mg.L^-1者入选,共41例,随机分为5个治疗组:血液透析组(HD)7例、连续血液滤过组(CVVH)10例、连续血液透析滤过组(CVVHDF)9例、血液灌流组(HP)7例、血液透析加灌流组(HPHD)8例。单次治疗前、后采血检测β2微球蛋白,计算并进行统计分析。结果:各组β2微球蛋白下降率分别为(-6.7±6.2)%、(41.8±12.0)%、(22.1±7.6)%、(30.1±3.4)%、(10.7±8.5)%。总清除量分别为(-3.3±3.0)mg、(23.5±8.6)mg、(14.6±6.3)mg、(17.7±2.4)mg、(7.1±5.6)mg。CVVH组最高,HD组最低。各组β2微球蛋白清除率分别为(-0.8±0.7)mg/h、(3.7±1.3)mg/h、(2.4±1.1)mg/h、(8.9±1.2)mg/h、(1.8±1.4)mg/h。HP组最高,HD组最低。结论:不同血液净化方式对β2微球蛋白清除效果不同,应依据临床需要选择适当的治疗方式。
Objective: To investigate the best way to remove uremic middle molecules through comparison between different blood purification modalities.Methods: Fourty-one hemodialysed patients were enrolled by the beta 2 microgloubulin screening(〉5 mg/L) from January to May 2007 in our center and divided randomly into five groups(HD,CVVH,CVVHDF,HP and HPHD,7,10,9,7,8 cases respectively).Blood was sampled before and after treatment.Decrement and clearance rate of beta 2 microglobulin were calculated and statistically analysed.Results: The beta 2 microglubulin decrement in five groups was(-6.7±6.2)%,(41.8±12.0)%,(22.1±7.6)%,(30.1±3.4)%,(10.7±8.5)% respectively.Total removal was(-3.3±3.0)mg,(23.5±8.6)mg,(14.6±6.3)mg,(17.7±2.4)mg,(7.1±5.6)mg respectively.CVVH ranked first.The clearance rates of beta 2 microglobulin were(-0.8±0.7)mg/h,(3.7±1.3)mg/h,(2.4±1.1)mg/h,(8.9±1.2)mg/h,(1.8±1.4)mg/h respectively.HP ranked the highest,HD ranked the lowest.Conclusion: The five modalities showed different results in beta 2 microglobulin remove.We should select proper modality to fulfill clinical requirement.