超纯透析液对慢性血液透析患者血清白介素-1β、白介素-6、C反应蛋白、β_2微球蛋白和脂蛋白(a)的影响  

The effects of ultrapure dialysate on serum inflammatory cytokines,C-reactive protein,2-microglobulin and lipoprotein(a) in long-term hemodialysis patients

作　　者：陶建瓴[1] 孙阳[1] 李雪梅[1] 刘士勤[1] 夏京华[1] 石涛[1] 段琳[1] 李艳[1] 李学旺[1] 

机构地区：[1]中国医学科学院 北京协和医院肾内科,北京100730

出　　处：《中国血液净化》2008年第5期248-251,共4页Chinese Journal of Blood Purification

摘　　要：目的观察超纯透析液对慢性血液透析患者血清白介素-1β、白介素-6、C反应蛋白、脂蛋白(a)、β2微球蛋白的影响。方法选择中国医学科学院,北京协和医院肾内科长期血液透析患者21例,随机分为超纯透析液和常规透析液组,均用低通量聚砜膜,前瞻性观察两组入组前1周、入组后1周、1月、6月和12月透析前指标有无差异。并在上述点观察各组透析中120分钟、透析后即刻上述指标较透析前有无变化。结果常规透析或超纯透析组在任一观察点的单次透析中120min和透析后即刻,上述指标较透析前水平没有变化。12月后,超纯组透析前血清白介素-1β较对照明显下降(P<0.05),对照组血清脂蛋白(a)水平较超纯组明显升高(P<0.05)。结论良好的透析膜生物相容性有利稳定透析过程对炎症指标的影响,长期使用超纯透析液能降低患者透析前血清白介素-1β水平,且维持血清Lp(a)水平稳定,它可能有利于改善长期血液透析患者微炎症状态和相关并发症。Objective The aim was to observe the effects of ultrapure dialysate （UPD） on serum interleukin-6, interleukin-1 （IL-1）, C-reactive protein, a2-microglobulin, and lipoprotein（a） [Lp（a）]. Method A controlled prospective randomized study was carried out on 21 stable patients dialyzed on low-flux synthetic polysulphone membrane and assigned to either UPD or conventional dialysate （CD）. Blood samples were collected at pre-dialysis, 120 minutes later during the dialysis and immediately post-dialysis. The variables were measured one week before the study, and one week, one month, six months and twelve months during the study. Results All parameters were not changed during the session. Lp（a） was significantly higher in CD group （283.88 ± 145.80 vs 120.90 ± 122.1 lmg/L, P〈0.05）, and IL-Ia was lower in UPD group （49.22 ± 14.18 vs 68.05±20.34 pg/mi,P〈0.05） at the end of study. Conclusions Biocompatible membrane is first of all to lessen dialysis related chronic inflammation, and ultrapure dialysate should further decrease the high risk of inflammation related atherosclerosis through decreasing IL-1a and preventing rise of Lp（a）.

关 键 词：超纯透析液 血液透析 炎症 脂蛋白A 白介素-1Β 

分 类 号：R459.5[医药卫生—治疗学]