尿毒症持续血液透析患者医院感染血清炎症指标的变化研究  

Study of serum inflammatory markers in uremia patients complicated with nosocomial infections undergoing continuous hemodialysis

作　　者：林崇亭 张惠芳[1] 方展[1] 

机构地区：[1]烟台市烟台山医院血透室,山东烟台264001

出　　处：《中华医院感染学杂志》2013年第15期3634-3636,共3页Chinese Journal of Nosocomiology

摘　　要：目的观察尿毒症持续血液透析并发医院感染患者血清炎症指标的变化,为临床治疗提供方法学依据。方法选取尿毒症持续血液透析并发医院感染患者86例,随机分为高通量血液透析(HFHD)组40例,低通量血液透析(LFHD)组46例,检测透析前和透析治疗1年后血清C反应蛋白(CRP)、白介素-6(IL-6)、白介素-8(IL-8)和肿瘤坏死因子-α(TNF-α)水平的变化。结果 HFHD组患者透析1年后,CRP、IL-6、IL-8及TNF-α分别为(5.18±2.41)mg/L、(217.31±51.62)ng/L、(201.95±35.56)ng/L及(400.31±81.67)ng/L,明显低于透析前的(7.43±1.78)mg/L、(354.24±61.28)ng/L、(261.91±37.16)ng/L及(553.25±82.53)ng/L,其差异有统计学意义(P<0.05);LFHD组患者透析1年后上述相关指标与透析前比较,差异无统计学意义;HFHD组患者透析1年后的上述各指标均明显低于LFHD组,其差异有统计学意义(P<0.05)。结论高通量透析膜可以减低血清中CRP、IL-6、IL-8及TNF-α的浓度,改善和缓解尿毒症持续血液透析并发医院感染患者微炎症状态,低通量血液透析的效果则相对不明显。OBJECTIVE To observe the changes of serum inflammatory markers in the uremia patients complicated with nosocomial infections who underwent continuous hemodialysis so as to guide the clinical treatment of this disease. METHODS A total of 86 patients with uremia who underwent the continuous hemodialysis were enrolled in the study ,they were randomly divided into high-flux hemodialysis （HFHD） group （40 cases） and the low flux hemodialysis （LFHD） group （46 cases）. The concentration of serum C reactive protein （CRP）, IL-6, IL-8, and TNF-α were compared between the predialysis and one year after the dialysis treatment. RESULTS In the HFHD group, the concentrations of CRP, IL-6, IL-8, and TNF-α were respectively （5.18 ± 2.41） mg/L, （217. 31 ± 51.62）ng/L, （201.95±35.56） ng/L and （ 400.31 ±81.67） ng/L, significantly lower than （7.43±1.78） mg/L , （354.24±61.28） ng/L, （ 261.91 ±37.16） ng/L, and （553.25±82.53） ng/L before the dialysis, the differ- ence was statistically significant （P〈0.05）. In the LFHD group, the difference in the related indicators discussed above between the predialysis and one year after the dialysis was not statistically significant the levels of the relat- ed indicators discussed above were significantly lower in the HFHD group than in the LFHD group one year after the dialysis, the difference was statistically significant （P〈0.05）. CONCLUSION High-flux dialysis membranes can reduce the concentration of CRP, IL-6, IL-8 and TNF-a, improve and alleviate the micro-inflammatory state of the uremic sustained hemodialysis patients, and the effect of the low-flux dialysis is not relatively significant.

关 键 词：尿毒症 血液透析 医院感染 炎症 研究 

分 类 号：R181.32[医药卫生—流行病学]