摘要
目的分析骨化三醇对维持性血液透析(MHD)患者微炎症指标和营养状态的影响.方法选取2017年8月至2018年8月四川省自贡市第四人民医院90例MHD患者为研究对象,随机分为骨化三醇治疗组(45例)和常规治疗组(45例).在常规透析基础上,骨化三醇治疗组辅以骨化三醇静脉注射12周.比较两组患者微炎症指标和营养状态.结果治疗后,治疗组(骨化三醇组、常规组)的白细胞总数、中性粒细胞绝对值、超敏C反应蛋白的含量、白细胞/淋巴细胞比值、血小板/淋巴细胞比值显著高于健康对照组,差异有统计学意义(P<0.05);两组患者白蛋白均有不同程度的降低(P<0.05);两组患者总胆固醇、甘油三脂水平有所增加,但差异无统计学意义(P>0.05);骨化三醇组及常规组患者改良定量主观整体评估(MQSGA)评分较常规组均有不同程度的升高,且骨化三醇组优于常规组(P<0.05);白细胞/淋巴细胞比值(NLR)、超敏C反应蛋白(hs-CRP)与平均Kt/V、透析时间呈正相关.骨化三醇治疗组白细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、超敏C反应蛋白(hs-CRP)及改良定量主观整体评估(MQSGA)评分较对照组降低更为显著(P<0.05);NLR、hs-CRP与平均Kt/V、透析时间呈正相关.结论骨化三醇在一定程度上可改善MHD患者微炎症及营养不良状态.
Objective To analyze the effects of calcitriol on microinflammatory indicators and nutritional status in maintenance hemodialysis(MHD)patients.Methods A total of 90 patients with MHD admitted to the Fourth People's Hospital of Zigong City from August 2017 to August 2018 were enrolled and divided into calcitriol-treated group and the control group,45 cases per group.On the basis of conventional dialysis,patients in the calcitriol-treated group supplemented with intravenous injection of calcitriol for 12 weeks.The microinflammatory indicators and nutritional status were compared between the two groups.Results After treatment,the total number of white blood cells,the absolute value of neutrophils,the content of hypersensitive c-reactive protein,the ratio of white blood cells to lymphocytes,and the ratio of platelets to lymphocytes in the treatment group(both the ossified triol group and the conventional group)were significantly higher than those in the control group(P<0.05).Both groups had different degrees of reduction in albumin(P<0.05).The levels of total cholesterol and triglyceride increased in the two groups,but the difference was not statistically significant(P>,0.05).Improved quantitative subjective overall evaluation(MQSGA)score of patients in both the ossified triol group and the conventional group increased to different degrees compared with the conventional group,and the ossified triol group was superior to the conventional group(P<0.05).White blood cell/lymphocyte ratio(NLR),hypersensitive c-reactive protein(hs-crp)were positively correlated with mean Kt/V and dialysis time.The NLR,PLR,hs-CRP and MQSGA score were significantly lower in the calcitrioltreated group than those in the control group,and the was significantly lower(P<0.05).NLR and hs-CRP were positively correlated with mean Kt/V and dialysis time.Conclusion Calcitriol can improve microinflammation and malnutrition in MHD patients to a certain extent.
作者
吴易聪
林云
赵大军
WU Yicong;LIN Yun;ZHAO Dajun(Fourth People's Hospital of Zigong City,Zigong,Sichuan 643000,China)
出处
《大医生》
2019年第20期157-159,共3页
Doctor
关键词
骨化三醇
维持性血透患者
微炎症
营养不良
calcitriol
maintenance hemodialysis patient
microinflammation
malnutrition
