【摘要】目的比较高通量血液透析(high-flux hemodialysis，HFHD)与常规低通量血液透析(lowflux hemodialysis，LFHD)联合血液透析滤过(hemodiafiltration，HDF)对维持性血液透析患者治疗的 有效性和安全性。方法选取维持性血液透析患者315 例，随机分为试验组(HFHD，3 次/周)与对照组 (LFHD 2 次/周+HDF 1 次/周)，随访24 个月。结果①试验组和对照组的死亡率分别为5.66%和9.55% (χ2=1.701，P=0.191)，住院率分别为27.04%和25.48%(χ2=0.100，P=0.752)，均无显著差异。②试验组和 治疗组治疗后单室尿素清除指数(1.70 ± 1.03 比1.37 ± 0.24,t=1.782，P =0.079)、尿素下降率 (75.08%±13.15% 比70.31%±10.69%, t=1.760，P=0.082)无显著差异。试验组血清β2微球蛋白降低 [(21.52±9.94)mg/L 比(27.28±16.51)mg/L, t=-2.148，P=0.034]，说明试验组对中分子毒素的清除优于对照组。③2 组均未发生透析器相关急性并发症和透析器相关不良事件。结论2 种透析方式总体有效性和安全性相当。HFHD 对中大分子毒素的清除更好，值得推广应用。

【Abstract】Objective To compare the efficiency and safety of high-flux hemodialysis (HFHD) and lowflux hemodialysis (LFHD) combined with hemodiafiltration (HDF) in maintenance hemodialysis (MHD) patients. Methods A total of 315 MHD patients were recruited and divided into trial group (HFHD, 3 times per week) and control group (LFHD 2 times per week and HDF once a week). They were followed up for 24 months. Results ①There were no significant differences in mortality rate (5.66% vs. 9.55%, χ2=1.701, P=0.191) and hospitalization rate (27.04% vs. 25.48%, χ2=0.100, P=0.752) between the trial group and the control group. ②The after dialysis single pool Kt/V values in the trial and control group were 1.70±1.03 and1.37±0.24 respectively (t=1.782, P=0.079), while urea reduction rates in the two groups were 75.08±13.15% and 70.31±10.69% respectively (t=1.760, P=0.082). After the treatment, serum β2 microglobulin in the trial group was significantly lower than that in the control group (21.52±9.94mg/L vs. 27.28±16.51mg/L, t=-2.148, P=0.034). ③ No dialyzer- related acute complications and dialyzer- related adverse events occurred in both groups. Conclusion The two hemodialysis methods were equally effective and safe. HFHD had a better clearance of medium macromolecular toxins and is recommended to be used clinically.