高通量血液透析对尿毒症患者胰岛素抵抗及左室结构和功能的影响被引量：28

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摘要目的观察高通量血液透析对维持性血液透析(MHD)患者胰岛素抵抗及心脏结构和功能的影响。方法MHD患者80例,均接受维持性血液透析治疗1年以上。非糖尿病肾病60例随机分为A组和B组,各30例;糖尿病肾病20例为C组。从门诊体检中心选20例健康体检者作为健康组。A组行常规血液透析,B组和C组行高通量血液透析,治疗6个月。检测TG、TC、ALB、FPG、FINS和HOMA-IR及hs-CRP。测定A、B、C组治疗前后血清hsCRP和稳态模型胰岛素抵抗指数(HOMA-IR),并应用心脏超声心动图测定LAD、LVEDd、LVEDs、LVPWT、IVST、LVMI、LVEF、E/A、CO。结果 A、B、C组TG、TC和FINS、HOMA-IR及hs-CRP均较健康组升高,(P均<0.05)。B、C组治疗6个月后PTH、hs-CRP、FINS、HOMA-IR均下降(P均<0.05),与治疗后A组相比P<0.05。B、C组治疗后LVEF、E/A及CO较治疗前升高(P均<0.05),与治疗后A组相比P<0.05。行MHD的患者血清HOMA-IR与hs-CRP水平呈正相关(r=0.857 3,P<0.05);hsCRP、HOMA-IR分别与LAD、LVEDd、LVEDs、LVPWT、IVST、LVMI呈正相关(r分别为0.762 5、0.850 2、0.812 3、0.802 8、0.802 1、0.835 6和0.684 7、0.757 1、0.824 2、0.837 9、0.856 2、0.931 4,P<0.05),与LVEF、E/A、CO呈负相关(r分别为-0.702 9、-0.804 8、-0.854 5和-0.902 5、-0.850 3、-0.865 4,P<0.05)。结论行MHD的患者存在微炎症状态和胰岛素抵抗,高通量血液透析较常规血液透析能明显改善胰岛素抵抗,并改善心功能。

作者王维平熊长青朱鹏

机构地区扬州市江都人民医院

出处《山东医药》 CAS 2014年第14期91-94,共4页 Shandong Medical Journal

关键词尿毒症血液透析高通量胰岛素抵抗心功能

分类号 R459.5 [医药卫生—治疗学]

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