摘要
目的观察常规血液透析(HD)、高通量血液透析(HFD)、血液灌流(HP)对终末期肾病(ESRD)维持性血液透析(MHD)患者体内炎性因子清除的疗效。方法选择透析龄3个月以上稳定的MHD患者60例,随机分为HD组、HFD组、HD+HP组,每组20例。3组患者分别在首次治疗前后及治疗3个月后透析前,测定患者C-反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、β2微球蛋白(β2-MG)血清含量,同时测定20例健康志愿者(对照组)CRP、IL-6、TNF-α、β2-MG血清含量。结果 MHD患者治疗前的CRP、IL-6、TNF-α、β2-MG水平均高于对照组(P<0.01),透析3组间差异无统计学意义(P>0.05)。HD组首次治疗后及治疗3个月后CRP、IL-6、β2-MG及TNF-α均升高,与治疗前比较差异无统计学意义(P>0.05)。HFD组合首次治疗后CRP、IL-6、β2-MG及TNF-α均下降,但与治疗前比较差异无统计学意义(P>0.05);治疗3个月后CRP、IL-6、β2-MG及TNF-α下降(P<0.05)。HD+HP组首次治疗后及治疗3个月后CRP、IL-6、β2-MG及TNF-α均下降(P<0.05)。治疗3个月后,HD+HP组的CRP、IL-6、β2-MG及TNF-α值低于HFD组(P<0.05),HD+HP组下降百分比高于HFD组(P<0.01)。结论 MHD患者存在微炎症状态,HFD和HP可以降低CRP、IL-6、β2-MG及TNF-ɑ水平,改善患者的微炎症状态,HP可能优于HFD。
Objective To observe the efficiency of clearing inflammatory factors through regular hemodialysis （ HD）, high-flux hemodialysis （ HFD）, hemoperfusion （HP） for end stage renal disease （ESRD） patients receiving maintenance hemodialysis （MHD）. Methods The 60 patients over 3-month regular dialysis were randomly divided into 3 groups ： HD group, HFD group, HD ＋ HP group, with 20 patients in each group. The serum levels of C reactive protein （ CRP）, interleukin 6 （ IL-6 ）, tumor necrosis factora （ TNF-ct ）, beta 2 microglohulin （132-MG） before and after the first dialysis as well as 3 months after treatment were measured by immune turbidimetry or enzyme linked immunosorbent assay （ELISA） in all the patients and 20 healthy volunteers （ control group）. Results Before treatment the serum levels of CRP, IL-6, TNF-α, β2-MG in MHD patients were significantly higher than those of control group （ P 〈 0.01 ）, however, there were no significant differences among the 3 dialysis groups （ P 〉0.05）. The serum levels of CRP,IL-6,β2-MG and TNF-et in HD group after the first dialysis and 3 months after treatment were increased,however,which had no significant differences as compared with those before treatment （ P 〉 0.05）. The serum levels of CRP, IL-6,132-MG and TNF-ct in HFD group after the first dialysis were decreased, however, which had no significant differences, as compared with those before treatment （ P 〉 0.05 ）, and these parameters were decreased after 3-month treatment, there were significant differences before treatment and after 3-month treatment （ P 〈 0.05 ）. The serum levels of CRP, IL-6,132-MG and TNF-α HD ＋ HP group after the first dialysis and after 3-month treatment were significantly decreased, as compared with those before treatment （ P 〈 0.05 ）. After 3-month treatment, the serum levels of CRP, IL-6,132-MG and TNF-cdn HD ＋ HP group were obviously lower than those in HFD group （ P 〈 0.05）. The decrease percentage of these parameters in HD ＋ HP was higher than that of HFD group （P 〈 0.01 ）. Conclusion Micro-inflammatory state exists in MHD patients. HFD and HP can reduce the levels of CRP, IL-6,132-MG and TNF-α and can improve the patients＇ micro-inflammatory state, furthermore, HP may be superior to HFD.
出处
《河北医药》
CAS
2012年第19期2897-2899,共3页
Hebei Medical Journal
关键词
肾透析
微炎症状态
高通量血液透析
血液灌流
renal dialysis
micro-inflammatory state
high-flux hemodilysis
hemoperfusion
