血液灌流联合血液透析对慢性肾衰竭患者血清炎性因子、Hcy、PTH及β2-MG的影响  

Influence of hemoperfusion combined with hemodialysis on inflammatory factors,serum Hcy,PTH and β2-MG of patients with chronic renal failure

作　　者：殷煜[1] 李蕊[1] 郝建荣[1] 

机构地区：[1]北京京煤集团总医院肾内科,北京102300

出　　处：《海南医学院学报》2015年第11期1499-1501,共3页Journal of Hainan Medical University

基　　金：北京市科技计划项目(D130502603406785)~~

摘　　要：目的：分析血液灌流联合血液透析对慢性肾衰竭患者血清炎性因子、同型半胱氨酸（Hcy）、甲状旁腺素（PTH）及β2微球蛋白（β2-MG）等指标的影响。方法：将2013年12月-2015年1月于北京京煤集团总医院接受治疗的慢性肾衰竭患者中选择94例作为研究病例,按照其就诊顺序随机分为两组。对照组47例采用常规血液透析治疗,观察组47例采用血液灌流联合血液透析进行治疗,检测、分析两组患者治疗前后血清白介素-1（IL-1）、白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、超敏C反应蛋白（hsCRP）、血磷（P）、Hcy、PTH及β2-MG、BUN、Scr等指标。结果：治疗后观察组患者血清IL-1、IL-6、TNF-α及hs-CRP水平（1.72±0.16）ng/L、（12.38±1.67）ng/L、（1.26±0.31）mg/L、（6.78±1.42）ng/mL均较本组治疗前和对照组治疗后相应数值明显降低（P〈0.05）;治疗后观察组患者血清PTH、Hcy及P水平均较本组治疗前和对照组治疗后相应数值明显降低（P〈0.05）;治疗后观察组患者血清β2-MG、BUN、Scr水平均较本组治疗前和对照组治疗后相应数值明显降低（P〈0.05）。结论：血液灌流联合血液透析治疗慢性肾衰竭疗效显著,不仅能够有效降低患者血清炎性因子水平,对Hcy、PTH及β2-MG清除效果显著,且能有效改善患者肾功能,值得临床推广和应用。Objective： To analyze the influence of hemoperfusion combined with hemodialysis on serum inflammatory factors, homocysteine （Hcy）, parathyroid hormone （PTH） and β2 microglobulin （β2-MG） and other indexes in patients with chronic renal failure. Methods： 94 cases with chronic renal failure treated in our hospital were randomly divided into two groups, according to the order of treatment. The control group of 47 patients were given regular hemodialysis treatment, the observation group of 47 cases was treated with blood perfusion combining with hemodialysis treatment. The serum interleukin -1 （IL-1）, interleukin-6 （IL-6）, tumor necrosis factor α （TNF-α）, high sensitive C reactive protein （hs-CRP）, phosphorus （P）, Hcy, PTH, BUN, β2-MG and Scr indexes of two groups of patients before and after treatment were detected. Results： After treatment, serum IL-1, IL-6, TNF-α and hs-CRP levels of observation group were （1.72±0.16） ng/L, （12.38±1.67） ng/L, （1.26±0.31）mg/L, （6.78±1.42） ng/mL, were significantly decreased compared with the group before treatment and control group after treatment （P〈0.05）. After treatment, serum PTH, Hcy and P levels of observation group were significantly decreased compared with the group before treatment and control group after treatment （P〈0.05）. After treatment, β2- MG, BUN, Scr levels of observation group were significantly decreased compared with the group before treatment and control group after treatment （P〈0.05）. Conclusion： the curative effect of blood perfusion combining with hemodialysis shows good effects on chronic renal failure, it can effectively reduce serum level of inflammatory factors, clean out Hcy, PTH, β2-MG sig- nificantly, and can effectively improve renal function and skin itching symptoms, thus it is worthy of clinical popularization and application.

关 键 词：血液灌流 血液透析 炎性因子 同型半胱氨酸 甲状旁腺素 Β2微球蛋白 

分 类 号：R692.5[医药卫生—泌尿科学]