不同血液透析方式对超敏心肌肌钙蛋白T水平影响.docVIP

不同血液透析方式对超敏心肌肌钙蛋白T水平的影响 　　【摘要】 目的：探讨低通量透析（LF-HD）、高通量透析（HF-HD）及血液透析滤过（HDF）对血浆超敏心肌肌钙蛋白T（hs-cTnT）水平的影响。方法：选取2015年7月-2016年2月在笔者所在医院血液净化中心进行长期透析的48例患者为研究对象（试验组），随机进行LF-HD、HF-HD及HDF治疗，并同期选取健康对照组30例。试验组患者每个透析治疗模式连续进行2周，3次/周，4 h/次；透析前后（间隔2周）分别检测hs-cTnT水平，有效浓度根据血液浓缩进行校正。结果：经LF-HD后患者hs-cTnT有升高趋势，但差异无统计学意义（P0.05），合并心血管病患者经LF-HD后hs-cTnT升高，差异有统计学意义（P=0.020）。经HF-HD及HDF治疗后患者hs-cTnT水平均降低，差异均有统计学意义（P0.05）。结论：血液透析患者在LF-HD后hs-cTnT水平无明显变化，而HF-HD及HDF后hs-cTnT水平明显降低，可以掩盖因急性心肌梗死引起的心脏生物标志物的增加。 　　【关键词】 低通量透析； 高通量透析； 血液透析滤过； 超敏心肌肌钙蛋白T 　　中图分类号 R459.5 文献标识码 A 文章编号 1674-6805（2016）21-0001-03 　　【Abstract】 Objective：To investigate the influences of low-flux hemodialysis（LF-HD），high-flux hemodialysis（HF-HD） and hemodialysis filtration（HDF） on the plasma level of high sensitive cardiac troponin T（hs-cTnT）.Method：Forty-eight hemodialysis（HD） patients from July 2015 to February 2016 in our hospital were included in this design as the experimental group，who were randomized to start dialysis with LF-HD，HF-HD or HDF.Each mode of dialysis lasted two consecutive weeks，three times a week，4 hours of every dialysis.The plasma levels of hs-cTnT were measured before and after dialysis，the effective values were corrected for extent of ultrafiltration.Result：After the treatment of LF-HD，the hs-cTnT tended to increase but the difference was not statistically significant（P0.05），while the hs-cTnT levels increased significantly in patients with cardiovascular disease，the difference was statistically significant（P=0.020）.The levels of hs-cTnT decreased significantly after the treatment of HF-HD and HDF，the differences were statistically significant（P0.05）.Conclusion：Cardiac biomarker hs-cTnT levels had no statistically difference after LF-HD in HD patients，while the hs-cTnT levels decrease significantly after HF-HD and HDF，which can mask the increases of cardiac biomarker caused by myocardial infarction. 　　【Key words】 Low-flux hemodialysis； High-flux hemodialysis； Hemodialysis filtration； High sensitive cardiac t