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目的 探讨连续性静静脉血液滤过 (CVVH)和血液透析 (HD)对急性肾衰竭 (ARF)患者血清肝细胞生长因子 (HGF)水平的影响。方法 2 8例确诊为ARF的患者 ,其中 19例进行常规HD治疗 ;9例进行CVVH治疗。用ELISA方法测定患者HD和CVVH不同时间血清及滤过液HGF水平。结果 ARF患者血清HGF水平显著升高于正常对照组 (P <0 0 0 1)。ARF患者经HD治疗后HGF呈明显下降趋势 ,治疗后 1h与治疗前血清HGF水平比较有显著性差异 (P <0 0 1) ;HD治疗结束时血清HGF水平与治疗前、治疗后 1h比较也均存在显著性差异 (P <0 0 0 1)。ARF患者CVVH治疗过程中血清HGF的水平无显著变化 (P >0 0 5 ) ;并且滤过液中未检测到HGF。结论 HD能降低ARF患者血清HGF水平 ,CVVH治疗对血清HGF的水平影响较小 ,提示CVVH较HD更适于ARF患者 (尤其是重症ARF患者 )治疗。
Objective To investigate the effects of continuous venous hemofiltration (CVVH) and hemodialysis (HD) on serum levels of hepatocyte growth factor (HGF) in patients with acute renal failure (ARF). Methods Twenty-eight patients with ARF were identified, of whom 19 received conventional HD and 9 received CVVH. The HGF levels of serum and filtrate of HD and CVVH patients at different time were measured by ELISA. Results The level of serum HGF in patients with ARF was significantly higher than that in the normal controls (P <0.01). The HGF level of ARF patients decreased obviously after HD treatment, and there was a significant difference (P <0.01) between the level of HGF and the level of serum HGF before treatment at 1 hour after treatment. The level of serum HGF at the end of HD treatment was similar to that before treatment and 1 hour after treatment There was significant difference (P <0.01). There was no significant change in serum HGF level during CVVH treatment in ARF patients (P> 0.05), and no HGF was detected in the filtrate. Conclusions HD can reduce serum HGF level in patients with ARF. CVVH treatment has little effect on serum HGF level, suggesting that CVVH is more suitable than HD for ARF patients (especially those with severe ARF).