RESUMO
Objective To compare the effects of different blood purification methods on the removal of large and medium molecular toxins in patients with maintenance hemodialysis(MHD), and to provide the clinical basis for selecting suitable dialysis modalities to prevent or delay the long term complications of uremic patients.Methods60 MHD patients with long term and stable hemodialysis were enrolled in this study.All of them were selected from the patients with insufficient hemodialysis.According to the digital table,60 patients were randomly divided into high flux hemodialysis (HFHD)group and hemodiafiltration (HDF) group,30 cases in each group.And before,3 months and 6 months after dialysis, the serum β2-MG,PTH and Cys C after dialysis were tested.Results The clearance of PTH in the HFHD group[(286.34±127.33)pg/mL] was significantly higher than that in the HDF group[(376.04±141.74)pg/mL],the difference was statistically significant(t=2.45,P<0.05).The clearance of β2-MG in the HDF group[(11.34±1.96)mg/L]was significantly higher than that in the HFHD group[(15.41±3.02)mg/L],the difference was significant(t=5.88,P<0.05).The clearance of Cys C in the HFHD group[(263.67±98.72)μg/dL]was significantly higher than that in the HDF group[(345.63±105.00)μg/dL],the difference was statistically significant(t=2.96,P<0.05).Conclusion Both two dialysis methods are very effective in the removal of large and medium molecular uremic toxins in patients.In the removal of patients with increased PTH,HFHD is more effective.In the removal of patients with increased β2-MG,HDF is more effective.In the removal of Cys C,HFHD is better.
RESUMO
Objective To investigate the clinical effects of prostaglandin E1 (PGE1) in the treatment ot chronic renal failure in the 2nd ～ 4th period.Methods 128 patients with CKDs at stage 2 to 4 were selected and randomly divided into the observation group and control group,64 cases in each group.Patients in control group were given routine drug treatment,and patients in observation group were given PGE1 on the basis of the control group.They all treated for 3 months.Renal function indicators before and after treatment,curative effect and adverse reaction were compared.Results There were no statistical differences in renal function indicators before treatment in two groups (t =0.27 ～ 0.95,P ＞ 0.05).After treatment,the 24 hours urinary protein (t =3.41,P ＜ 0.05),creatinine clearance rate (t =4.04,P ＜ 0.05),serum creatinine (t =4.15,P ＜ 0.05),serum urea nitrogen (t =3.92,P ＜ 0.05) between the two groups had statistical differences.Total effective rate of the observation group was 84.37％,which was significantly higher than 57.81％ of the control group (x2 =5.63,P ＜ 0.05).There was no adverse reaction observed in observation group.Conclusion PGE1 might improve patients' proteinuria and renal function in the current situation of lacking effective treatment.