不同透析方式对晚期糖基化终末产物清除作用的研究

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1、不同透析方式对晚期糖基化终末产物清除作用的研究作者：王悦芬，冯忖，徐金升单位：050011石家庄市，河北医科大学第四医院肾内科【摘要】口的通过不同透析方式对晚期糖基化终末产物(AGEs)清除作用进行比较，探讨能更好清除中分子毒素的透析方式，指导临床治疗。方法20例尿毒症患者，接受血液透析滤过(HDF)联合高通量透析(HFHD)10例，接受常规血液透析(CHD)治疗10例，用荧光分光光度计法对透析患者血清AGEs水平进行测定(治疗6个月前后以及单次HDF、HFHD、CHD治疗前后)，并对其进行比较分析。结果单

2、次HDF、HFHD治疗血清AGEs水平均明显下降(P<0.05),但2组间差异无统计学意义(P>0.05),单次CHD治疗血清AGEs水平差异无统计学意义(P>0.05)；治疗后6个月透析前AGEs水平各组差异均无统计学意义(P>0.05),但I1DF+IIFIID组IIDF低于CIID组(P<0.05)□结论HDF、IIFIID治疗是清除尿毒症患者体内AGEs的一条重要途径；长期联合HFHD对AGEs清除作用明显优于CHD治疗。【关键词】尿毒症；晚期糖基化终末产物；血液透析滤

3、过；高通量血液透析；维持性血液透析TheeffectsofdifferentbloodpurificationmodalitiesineliminatingAGEsinpatientswithchronicrenalfailureWANGYuefen,FENGCun,XUJinsheng.DepartmentofNephrology,TheFourthHospitalofHebeiMedicalUniversity,Shijiazhuang050011[Abstract]ObjectiveToanalyze

4、theeffectsofdifferentpurificationmodalitiesineliminatingadvaneedglycationendproducts(AGEs)inpatientswithuremia,andtoevaluatetheirrelatedclinicalvalue・Methods20uremiapatients,whoacceptedvariousbloodpurificationmodalitiesweredividedinto2groupsasHDF+HFHDgroup

5、(10cases)andCHDgroup(10cases)・TheAGEswasmeasuredbyimmunofluorescencespectrophotometrybeforetreatmentand6monthsafterbloodpurification,andtherelatedfactorswereanalysed・ResultsTheserumAGEslevelsweresignificantlydifferentbetweenpredialysisandpostdialysisinpati

6、entstreatedwithHDFandHFHD,whiletherewasnosignificantdifferencewithCHDtreatment(P>0.05)・Beforeandaftersixmonthstreatment,thelevelsofAGEsoftwogroupswerenosignificantdifference(P>0・05),whilethelevelsofAGEsinHDF+HFHDgroupweresignificantlylowerthanthoseof

7、CHDgroup(P<0.05).ConclusionThealterationofserumAGEsareassociatedwithvariousbloodpurificationmethods.TheAGEslevelislowerinpatientstreatedwithlongtermHDF+HFHDthanthosetreatedwithCHD,suggestingthatHDFandHFHDmaybeanimportantdialysismodalityincleaningAGEsinp

8、atientswithuremia・[Keywords]uremia;advancedglycationendproducts:hemodiafi1tration;highfluxhemodialysis;themaintenancehemodialysis随着透析患者的生存时间的延长，尿毒症毒素潴留相关的并发症不断增多，其中作为心血管疾病的独立危险因素晚期糖基化终产物(AGEs)倍受关注[1],但对其清除作用的