不同血液净化方式对终末期肾脏病患者不宁腿综合征的影响.doc

不同血液净化方式对终末期肾脏病患者不宁腿综合征的影响 张文莹 付光生 郑秀芬 张蕾 王廷娟 山东省临朐县人民医院， 山东临朐 262600 【摘要】 目的 探讨不同血液净化方式对终末期肾脏病(ESRD)患者不宁腿综合征（RLS）的疗效及机制。方法 根据国际RLS委员会的诊断标准对ESRD伴RLS的患者进行RLS评分，将符合条件的26例患者随机分为2组，血液透析灌流（HDP）组:采用每周2次血液透析(HD), 1次HDP治疗；血液透析滤过（HDF）组:采用每周2次HD, 1次HDF治疗,治疗3个月。观察患者甲状旁腺激素浓度（iPTH）、RLS评分的变化。结果 治疗后HDP组 iPTH明显下降（P＜0.05），HDF组治疗前后无明显变化(P0.05)；HDP组治疗后RLS评分较前明显下降（P＜0.01），HDF 组治疗后RLS评分较前下降（P＜0.05）,但HDP组下降幅度明显大于HDF组（P＜0.05）。结论 HDP及HDF两种血液净化方式均能改善终末期肾脏病患者RLS症状，但HDP效果更佳。两者改善RLS症状的机制除与大分子毒素清除有关外，中分子毒素如炎症介质等的清除可能也起一定的作用。 【关键词】：血液透析灌流、血液透析滤过、不宁腿综合征 The influence of different blood purification profiles on restless legs syndrome in end-stage renal disease patients. ZHANG Wen-ying ,FU Guang-sheng,ZHENG Xiu-fen,ZHANG Lei,WANG Ting-juan,Peoples Hospital of Linqu,LinQu 262600,Shandong Province 【Abstract】 Objective To evaluate the effect of different blood purification profiles on restless legs syndrome (RLS) in end-stage renal disease (ESRD) patients. Methods The severity of RLS was graded following the diagnostic criteria of International Restless Legs Syndrome Study Group (IRLSSG) in ESRD patients. Twenty-six patients were divided in two groups randomly and equally:blood dialysis perfusion (HDP) group ( hemodialysis (HD) twice/week; HDP once/week), blood dialysis filter (HDF) group (HD twice/week; HDF once/week).The treatment lasted for 3 months.Observation of patients with serum parathyroid hormone (iPTH),the change of RLS scores. Results iPTH significantly decreased(P＜0.0)in group HDP after teratment ，but in group than before no significantly difference.The RLS scores in HDP group after treatment decreased obviously (P 0.01),and it declined (P 0.05) in HDF group compared with the former.,but the HDP group decreased significantly greater than HDF group (P 0.05).Conclusion RLS in the patients can be improved by the two blood purification methods we used, but HDP is the better.The mechanisms that they improve RLS symptoms both associated with macromolecule toxins removal,and middl