目的 研究长期高通量血液透析患者肺通气功能的变化.方法 选取终末期肾脏病普通血透患者87例,给予高通量血液透析治疗,并观察普通血液透析时、高通量血液透析1、3、6、12个月时血红蛋白、心功能、血气指标、白蛋白、电解质(钙、磷)、血清铁蛋白(SF)、超敏C-反应蛋白(hs-CRP)、血β2微球蛋白(β2-MG)、用力肺活量(FVC%)、第1 秒用力肺活量(FEV1%)、用力呼气1 s率(FEV1/FVC%)、用力呼气中期流速(FEF25%~75%)等指标的变化,并进行相关性分析.结果 随着高通量血液透析及时间的延长,SF、hs-CRP、β2-MG、水平逐渐降低(P<0.05);FVC%、FEV1%、FEV1/FVC%、 FEF25%~75%逐渐升高,随着透析时间的延长(>3个月),肺通气功能明显改善(P<0.05).单因素及多因素线性综合回归表明:SF、hs-CRP、β2-MG水平与肺通气功能多个指标呈显著负相关(P<0.05).结论 长期高通量血液透析患者(>3个月)因SF、hs-CRP、β2-MG等物质的清除,从而使肺通气功能得以改善.%Objective To investigate pulmonary ventilation change after long-term high-flux hemodialysis in end stage renal disease (ESRD) hemodialysis patients.Methods We chose 87 cases of low flux hemodialysis ESRD patients,changed their therapy into high flux hemodialysis,observed the changes of hemoglobin,cardiac function,blood gases parameters,albumin,electrolytes (calcium,phosphorus),SF,hs-CRP,β2-MG,FVC%,FEV1%,FEV1/FVC%,FEF25%-75% and other parameters 1,3,6 and 12 months after the therapy and analyzed their correlations.Results SF,hs-CRP,β2-MG concentration decreased and FVC%,FEV1%,FEV1/FVC%,FEF25%-75% increased after long-term high-flux hemodialysis.With the extension of the high-flux hemodialysis time (>3 months),lung ventilation dysfunction improved significantly (P<0.05).Single factor and multifactor linear regression analysis indicated that SF,hs-CRP,β2-MG concentration levels and lung ventilation function were negatively correlated (P<0.05).Conclusions Long-term (>3 months) high-flux hemodialysis patients significantly improve their pulmonary ventilation function due to the clearance of SF,hs-CRP,and β2-MG.
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