摘要目的 研究高通量血液透析对患者营养状况的影响.方法 采用前瞻性、自身对照研究.30例维持性常规低通量血液透析患者,转换为高通量血液透析6个月.试验前(0个月)、试验后3、6个月分别测定白蛋白、胆固醇、铁蛋白水平,计算标准化的蛋白氮出现率相当蛋白质(nPNA),测量瘦体重、握力并进行食欲量表评分.结果 转换为高通量透析后患者白蛋白、胆固醇、铁蛋白浓度比较差异无统计学意义(P<0.05).瘦体重在试验开始0、3、6个月分别为(39.7±8.7)kg、(35.0±6.8)kg、(34.5±1.3)kg,试验前、后比较差异有统计学意义(P<0.05),而握力水平比较分别为(22±10)kg、(25±11)kg、(25±10)kg.nPNA及食欲母表分数在试验前、后比较差异无统计学意义(P>0.05).结论 高通量血液透析会对患者的营养状况产生一定影响.

abstractsObjective Current prospective,self-controled study designed to detect whether changing to high-flux dialysis could improve the nutritional condition with maintain low-flux hemodialysis. Methods 30 patients with maintain low-flux hemodialysis were included. After switching to high-flux dialysis, dialysis prescription kept unchanged except changed from using low-flux F7HPS dialyzer to high-flux FX60 dialyzer. Ultrapure dialysate was implied. Predialysis blood samples were collected for detecting albumin, cholesterin, ferritin; normalized protein equivalent of protein nitrogen appearance (nPNA) were calculated, lean body mass( LBM) and Spring-grip dumbbells were measured at 0,3 and 6 months after entering the study. Results The albumin, cholesterin, ferritin kept unchanged during the study process. LBM decreased significantly after shifting to high-flux dialysis,which were (39.7±8.7)kg,(35.0±6.8)kg,(34.5± 1.3)kg(P<0.05)respectively at 0,3 and 6 months. Spring-grip dumbbells increased after shifting to high-flux dialysis, which were (22±10)kg,(25±11)kg,(25±10)kg(P<0.05)respectively at 0,3 and 6 months.nPNA and appetite scores kept unchanged during the study procees. Conclusions The results shows that shifting from low flux to high-flux hemodialysis could influence the nutritional condition in maintain hemodialysis.