{"id":5311,"date":"2023-07-17T20:25:21","date_gmt":"2023-07-18T01:25:21","guid":{"rendered":"https:\/\/staging.advancedrenaleducation.com\/wparep\/asiapacific\/?post_type=article&p=5311"},"modified":"2023-07-17T21:55:09","modified_gmt":"2023-07-18T02:55:09","slug":"hdf%e5%9c%a8%e7%94%9f%e5%8c%96%e4%bb%a5%e5%8f%8a%e8%87%a8%e5%ba%8a%e7%9a%84%e7%9b%8a%e8%99%95-biochemical-and-clinical-benefits-of-hdf","status":"publish","type":"article","link":"https:\/\/staging.advancedrenaleducation.com\/wparep\/asiapacific\/article\/hdf%e5%9c%a8%e7%94%9f%e5%8c%96%e4%bb%a5%e5%8f%8a%e8%87%a8%e5%ba%8a%e7%9a%84%e7%9b%8a%e8%99%95-biochemical-and-clinical-benefits-of-hdf\/","title":{"rendered":"HDF\u5728\u751f\u5316\u4ee5\u53ca\u81e8\u5e8a\u7684\u76ca\u8655"},"content":{"rendered":"

HDF\u76f8\u8f03\u65bcHD\uff0c\u63d0\u5347\u4e86\u03b22-microglobulin (\u03b22\u5fae\u7403\u86cb\u767d)\u4ee5\u53caOsteocalcin \u00a0(\u9aa8\u9223\u7d20)\u7684\u6e05\u9664\uff1b\u6bd4\u8d77\u9ad8\u900f\u91cfHD\uff0cHDF\u63d0\u5347\u4e8630\u201340%\u7684\u6e05\u9664\u7387 (1)\u3002\u4e00\u4e9b\u5927\u578b\u4e16\u4ee3\u7814\u7a76\u767c\u73fe\uff0c\u9577\u671f\u4f7f\u7528\u5c0d\u6d41\u6cbb\u7642\uff0c\u6709\u52a9\u65bc\u6e1b\u7de9\u03b22-microglobulin\u985e\u6fb1\u7c89\u6c89\u7a4d\u7684\u9032\u5c55(2,3)\uff0c\u6e1b\u5c11\u8155\u9053\u75c7\u5019\u7fa4 (Carpal Tunnel Syndrome, CTS)\u767c\u751f\uff0c\u4ee5\u53ca\u5176\u4ed6\u76f8\u95dc\u7684\u75be\u75c5\u8868\u5fb5\u3002\u9019\u6a23\u7684\u597d\u8655\u53ef\u80fd\u4f86\u81ea\u65bc\u5e38\u898f\u4f7f\u7528\u8d85\u7d14\u900f\u6790\u6db2\uff0c\u6216\u662f\u63a5\u89f8\u8f03\u5c11\u7684\u975e\u751f\u7269\u76f8\u5bb9\u6027\u7269\u8cea\uff0c\u4ee5\u9054\u5230\u9810\u9632\u708e\u75c7\u7684\u6548\u679c\uff0c\u800c\u914d\u5408\u5c0d\u6d41\u7684\u8f49\u904b\u6a5f\u5236\u4e5f\u53ef\u4ee5\u589e\u52a0\u03b22-microglobulin\u4e4b\u79fb\u9664 (4-13)\u3002<\/p>\n

\u4e00\u500b\u61c9\u7528\u76f4\u63a5\u900f\u6790\u6db2\u91cf\u5316\u7814\u7a76\u6cd5\u7684\u524d\u77bb\u6027\u7814\u7a76\u767c\u73fe\uff0c\u76f8\u8f03\u65bc\u9ad8\u900f\u91cfHD\uff0c\u5f8c\u7a00\u91cb\u6cd5\u7684HDF\u53ef\u4ee5\u63d0\u534715-20%\u7684\u78f7\u9178\u9e7d\u6e05\u9664\u7387 (14)\u3002<\/p>\n

\u7814\u7a76\u6307\u51fa\uff0cHDF\u5c0d\u65bc\u67d0\u4e9b\u6eb6\u8cea\u6709\u66f4\u9ad8\u7684\u6e05\u9664\u7387\uff0c\u5305\u542bComplement factor D (\u4e00\u7a2e\u4fc3\u767c\u708e\u4ecb\u8cea) \u00a0(15)\u3001 leptin (16kDa, \u8207\u6291\u5236\u98df\u617e\u6709\u95dc) \u00a0(16)\u3001FGF23 (30kDa, \u8207\u9aa8\u9abc\u4ee3\u8b1d\u75be\u75c5\u4ee5\u53ca\u8840\u7ba1\u9223\u5316\u6709\u95dc) \u00a0(17,18)\u3001PTH \u00a0(19)\u3001 \u591a\u7a2e\u7d30\u80de\u6fc0\u7d20(cytokines) \u00a0(13,20,21)\uff0c\u4ee5\u53ca\u7cd6\u5316\u7d42\u7522\u7269 (Advanced Glycation End-products, AGEs) \u548c AGE\u524d\u9a45\u7269 (22)\u3002<\/p>\n

\u6839\u64da\u4e00\u4e9b\u524d\u77bb\u6027\u7814\u7a76\uff0c\u5305\u542bRISCAVID\uff0c\u986f\u793aHDF\u6cbb\u7642\u53ef\u4ee5\u964d\u4f4eCRP (C-reactive protein) \u3001\u5176\u4ed6\u654f\u611f\u7684\u767c\u708e\u751f\u7269\u6a19\u8a18 (\u5982 IL-6) \u3001\u4ee5\u53ca\/\u6216\u4fc3\u767c\u708e\u53cd\u61c9\u7d30\u80de\u7684\u6c34\u5e73 (23)\u3002\u5728\u6700\u8fd1\u7684\u7d71\u5408\u5206\u6790\u4e2d\u767c\u73fe\uff0c\u9577\u671f\u4f7f\u7528HDF\u8207\u964d\u4f4e\u611f\u67d3\u767c\u751f\u6709\u95dc\u9023\uff0c\u539f\u56e0\u53ef\u80fd\u4e3b\u8981\u4f86\u81ea\u65bc\u5e38\u898f\u4f7f\u7528\u8d85\u7d14\u900f\u6790\u6db2\uff0c\u5c11\u90e8\u5206\u539f\u56e0\u53ef\u80fd\u8207\u6e05\u9664\u4fc3\u767c\u708e\u4ecb\u8cea\u6709\u95dc (24)\u3002<\/p>\n

\u4e00\u4e9b\u81e8\u5e8a\u5831\u544a\u4e5f\u767c\u73fe\uff0cHDF\u53ef\u4ee5\u6e1b\u5c11\u7d05\u8840\u7403\u751f\u6210\u7d20 (Erythropoiesis stimulating agent, ESA)\u4f7f\u7528\uff0c\u9019\u9805\u597d\u8655\u53ef\u80fd\u6b78\u529f\u65bc\u7d05\u8840\u7403\u751f\u6210\u6291\u5236\u7269\u8cea (erythropoietic inhibitor substances)\u7684\u8f03\u9ad8\u6e05\u9664\u6548\u679c\u3001\u4f7f\u7528\u8f03\u9ad8\u54c1\u8cea\u7684\u900f\u6790\u7528\u6c34\u3001\u4ee5\u53ca\u6e1b\u5c11\u611f\u67d3\u7684\u7d9c\u5408\u6548\u679c(25)\u3002\u7136\u800c\uff0cHDF\u76f8\u8f03\u65bcHD\u53ef\u4ee5\u6e1b\u5c11ESA\u963b\u6297\u6027\u5230\u4ec0\u9ebc\u7a0b\u5ea6\u5c1a\u672a\u78ba\u8a8d\uff0c\u5176\u4f5c\u7528\u5728\u524d\u77bb\u6027\u96a8\u6a5f\u8a66\u9a57\u6240\u9810\u5148\u8a08\u5283\u7684\u6b21\u7d1a\u5206\u6790 (26)\u3001\u6216\u6700\u8fd1\u7684\u7d71\u5408\u5206\u6790 (27)\u4e2d\u672a\u80fd\u78ba\u8a8d\u3002\u7121\u8ad6\u5982\u4f55\uff0c\u5728\u5927\u578b\u89c0\u5bdf\u7814\u7a76\u4e2d(28)\uff0c\u4ecd\u53ef\u770b\u5230\u75c5\u60a3\u7d05\u8840\u7403\u751f\u6210\u56e0\u5b50\u7684\u4f7f\u7528\u91cf\u986f\u8457\u6e1b\u5c11\u3002<\/p>\n

\u5728\u6bd4\u8f03HDF\u8207\u50b3\u7d71HD\u6cbb\u7642\u6642\uff0c\u89c0\u6e2c\u5230\u900f\u6790\u4e2d\u7684\u4f4e\u8840\u58d3\u767c\u751f\u662f\u986f\u8457\u7684\u6e1b\u5c11\uff0c\u9019\u6a23\u7684\u72c0\u6cc1\u4e5f\u540c\u6a23\u5728\u5fc3\u8840\u7ba1\u9ad8\u98a8\u96aa\u75c5\u4eba\u4e2d\u770b\u5230 (29)\u3002HDF\u7684\u8840\u6d41\u52d5\u529b\u7a69\u5b9a\u597d\u8655\uff0c\u4e3b\u8981\u662f\u4f86\u81ea\u65bc\u76f8\u5c0d\u4f4e\u6eab\u5ea6\u7684\u88dc\u5145\u6db2\u8f38\u5165\u8840\u6db2\uff0c\u5f62\u6210\u964d\u6eab\u5e73\u8861\u539f\u7406 (\u5982\u4f4e\u6eab\u900f\u6790\u6548\u76ca)\u800c\u975e\u88dc\u5145\u6db2\u4e2d\u7684\u9ad8\u9209\u96e2\u5b50\u6fc3\u5ea6\u3001\u4ee5\u53ca\/\u6216\u79fb\u9664\u8840\u7ba1\u64f4\u5f35\u4ecb\u8cea\u7684\u7d50\u679c\u3002<\/p>\n

\u71df\u990a\u72c0\u6cc1\u7684\u7dad\u6301\u4e5f\u662f\u900f\u6790\u5145\u5206\u6027\u7684\u91cd\u8981\u6307\u6a19\u3002\u5118\u7ba1\u56e0\u70ba\u8f03\u9ad8\u6548\u7387\u53ef\u80fd\u589e\u52a0\u80fa\u57fa\u9178\u4ee5\u53ca\/\u6216\u71df\u990a\u7d20\u7684\u6d41\u5931\uff0cHDF\u76f8\u8f03HD\uff0c\u901a\u5e38\u53ef\u4ee5\u4fdd\u6301\u6bd4\u8f03\u597d\u7684\u8eab\u9ad4\u7d44\u6210\u4ee5\u53ca\u71df\u990a\u72c0\u614b\uff0c\u5373\u4f7f\u91dd\u5c0d\u71df\u990a\u4e0d\u826f\u7684\u60a3\u8005\u4e5f\u662f (33,34)\u3002\u524d\u77bb\u6027\u8ffd\u8e64\u4e00\u5e74\u7684\u7814\u7a76\u767c\u73fe\uff0c\u76f8\u8f03\u9ad8\u900f\u91cfHD\u6cbb\u7642\uff0cHDF\u6cbb\u7642\u60a3\u8005\u7684\u808c\u8089\u91cf\u7dad\u6301\u8f03\u597d\uff0c\u86cb\u767d\u8cea\u651d\u53d6\u589e\u52a0\u4e26\u6e1b\u5c11\u767c\u708e\u72c0\u614b\u3002\u9019\u4e5f\u652f\u6301\u4e86\u9019\u6a23\u7684\u5047\u8a2d\uff1a\u9069\u5ea6\u7684HDF\u6cbb\u7642\u5291\u91cf\u53ef\u4ee5\u63d0\u5347\u9ad4\u529b\u6d3b\u52d5\u3001\u5c0d\u71df\u990a\u72c0\u614b\u6709\u52a9\u76ca\u3001\u4e26\u9810\u9632\u900f\u6790\u60a3\u8005\u7684\u86cb\u767d\u80fd\u91cf\u6d88\u8017 (35)\u3002<\/p>\n

\u7406\u60f3\u7684\u9aa8\u9abc\u7926\u7269\u8cea\u75be\u75c5\u7ba1\u7406\uff0c\u91cd\u9ede\u662f\u9810\u9632\u9aa8\u8cea\u75be\u75c5\u60e1\u5316\u4ee5\u53ca\u8840\u7ba1\u9223\u5316\uff0c\u9019\u53ef\u80fd\u85c9HDF\u800c\u53d7\u76ca (36)\u3002\u5728\u6a6b\u65b7\u7814\u7a76 (Cross-sectional Study)\u4e2d\uff0cHDF\u88ab\u8a8d\u70ba\u5c0d\u7926\u7269\u8cea\u548c\u9aa8\u8cea\u751f\u7269\u6a19\u8a18\u5e36\u4f86\u52a9\u76ca (19)\u3002\u5728CONTRAST\u7814\u7a76\u4e2d\uff0c\u900f\u6790\u524d\u7684\u78f7\u96e2\u5b50\u6fc3\u5ea6\u53ef\u5728\u5e73\u7a69\u72c0\u614b\u4e0b\u53ef\u4ee5\u6e1b\u5c116%\uff0c\u800c\u670964-74%\u7684\u60a3\u8005\u78f7\u96e2\u5b50\u6fc3\u5ea6\u53ef\u4ee5\u9054\u5230\u900f\u6790\u6cbb\u7642\u524d\u61c9\u6709\u7684\u76ee\u6a19\u503c (37)\u3002\u53ef\u80fd\u7684\u539f\u56e0\uff0c\u5305\u542b\u63d0\u5347FGF23\u6e05\u9664\u7387 (+20%)\u3001\u589e\u52a0 calcidiol\u53cd\u61c9\u6027 (+30%)\uff0c\u4f46\u6709\u95dcsclerostin\u4ee5\u53caalkaline phosphatase\u7684\u6fc3\u5ea6\u51fa\u73fe\u6709\u5206\u6b67\u7684\u7d50\u679c (18, 38-41)\u3002\u7136\u800c\uff0c\u52d9\u5fc5\u4e86\u89e3\u4e8c\u50f9\u96e2\u5b50\u7684\u8655\u65b9(\u9223\u3001\u9382)\u3001\u6cbb\u7642\u6642\u9593\u3001\u4ee5\u53ca\u78f7\u9178\u9e7d\u7d50\u5408\u5291\u7684\u985e\u578b(\u542b\u9223\u3001\u6216\u4e0d\u542b\u9223)\u4ecd\u662f\u89e3\u91cb\u9aa8\u7926\u751f\u7269\u6a19\u8a18\u6539\u8b8a\u7684\u4e3b\u8981\u5e72\u64fe\u56e0\u5b50(42-44)\u3002<\/p>\n

\u5065\u5eb7\u76f8\u95dc\u7684\u751f\u6d3b\u54c1\u8cea(HRQOL)\u7814\u7a76\u4e5f\u51fa\u73fe\u6709\u5206\u6b67\u7684\u7d50\u679c(45)\u3002\u4e00\u4e9b\u4ea4\u53c9\u7814\u7a76\u652f\u6301HDF\u53ef\u4ee5\u63d0\u5347\u751f\u6d3b\u54c1\u8cea\uff0c\u4f46\u8a31\u591a\u96a8\u6a5f\u7684\u5e73\u884c\u5206\u7d44\u81e8\u5e8a\u8a66\u9a57\uff0c\u537b\u767c\u73feHDF\u6c92\u6709\u3001\u6216\u662f\u50c5\u6709\u9650\u5730\u63d0\u5347\u751f\u6d3b\u54c1\u8cea\u3002\u4e0d\u904e\uff0cHDF\u60a3\u8005\u7684\u751f\u6d3b\u54c1\u8cea\u8cc7\u6599\u5f88\u5c11\u3001\u4e14\u54c1\u8cea\u4e0d\u4e00\uff0c\u52a0\u4e0a\u8abf\u67e5\u65b9\u6cd5\u4e0d\u540c\u3001\u8abf\u67e5\u7814\u7a76\u5c0d\u8c61\u7684\u7570\u8cea\u6027\u9ad8\u3001\u4e0d\u540c\u7684\u6cbb\u7642\u5291\u91cf\u7b49\u56e0\u7d20\uff0c\u5c0e\u81f4\u7814\u7a76\u7d50\u679c\u4e0d\u4e00\u81f4\u3002<\/p>\n

(Translated from Website link: https:\/\/staging.advancedrenaleducation.com\/wparep\/article\/biochemical-and-clinical-benefits-of-hdf\/)<\/p>\n

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