不同透析方式对患者微炎症状态和营养状况的临床观察  

Different dialysis methods on clinical observation of micro inflammation and nutritional state in maintence hemodialysis patients

作　　者：张俊[1] 岳华[1] 

机构地区：[1]新疆维吾尔自治区人民医院肾病科,新疆乌鲁木齐830001

出　　处：《国际泌尿系统杂志》2015年第3期399-403,共5页International Journal of Urology and Nephrology

摘　　要：目的探讨常规血液透析和高通量血液透析两种不同治疗方式对维持性血液透析患者微炎症状态和营养状况的影响。方法选取50例维持性血液透析患者随机分成常规透析（CHD）和高通量透析（HFHD）两组，分别测定两组患者入组后首次透析（透析前）和治疗3个月后（透析前）的血浆白蛋白（Alb）、血清C反应蛋白（CRP）、白细胞介素-6（IL-6）的水平进行比较，同时比较治疗前后体重指数、肱三头肌皮肤皱褶厚度（TSF）、上臂围（MAC）和上臂肌围（MAMC）的变化。结果CHD组治疗3个月后对IL-6、CRP清除差异无统计学意义（P〉0．05），对Alb的影响差异无统计学意义（P〉0．05）；HFHD组治疗3个月后对IL-6、CRP清除差异有统计学意义（P〈0．05），对Alb的提升差异有统计学意义（P〈0．05）；HFHD组治疗3个月后TSF、MAC测量值升高，但是差异无统计学意义（P〉0．05），两组治疗后对BMI、MAMC的测量值差异无统计学意义。结论高通量透析与常规透析相比对IL-6和CRP等微炎症细胞因子的清除能力更显著，对改善微炎症状态有积极作用；且与常规透析相比对营养状态的改善也有-定帮助作用。Objectives To investigate the effects of high - fluxhemodialysis（HFHD） and conventional he- modialysis（CHD） on maintenance hemodialysis patients with the micro inflammation state and the nutritional status. Methods Selection of 50 patientsand divide them into two groups randomly. Respectively using low - flux dialyzer and high - flux dialyzer. Serum indicators On two groups for the first time dialysis and 3 months after treatment , such as ： hemoglobin （Hb） , interleukin - 6 （ IL - 6 ） , serum c - reactive protein （CRP） , albumin （Alb） was analyzed by change. Record subjective global assessment（SGA） , records into groups and treatment after 3 months of body weight, body mass index （bmi） , triceps skin fold thickness （TSF） , upper arm week of middle diameter （ MAC ） and upper ann muscle in middle weeks size（MAMC）. Using Vernier calipers measurement TSF MAC is measured with a flexible rule to calculate the MAMC. Results CHD group 3 months after treatment of IL - 6, CRP has no statistical signif- icance（ P 〉 0. 05 ） , the Alb and Hb has no statistical significance （ P 〉 0.05 ） ;HFHD group 3 months after treat- ment the IL- 6, CRP removal was statistically significant（ P 〈 0.05 ）, the Alb ascension was statistically significant （ P 〈 0.05 ） ; HFHD with CHD group 3 mouths after treatment, triceps skinfold, upper arm middle diameter measured values rise, has no statistical significant （ P 〉 0.05 ）, body weight, BMI, the measured value of the MAMC without statistical significance. Conclusions Compared to CHD group, HFHD group is more effective in removing mac- romolecule toxins and inflammatory cytokines. HFHD group also have significant higher nutritional state.

关 键 词：透析 炎症 营养状况 

分 类 号：R459.5[医药卫生—治疗学]