不同血液净化方式对血液透析患者微炎症与营养状况的影响  

The influence of various blood purification methods on microinflammation and nutrition status in patients with maintenance hemodialysis

作　　者：门雯瑾[1] 丁致民[1] 

机构地区：[1]北京积水潭医院肾内科,北京100035

出　　处：《中国临床医生杂志》2015年第10期20-23,共4页Chinese Journal For Clinicians

摘　　要：目的探讨血液灌流(HP)联合血液透析与单纯透析(HD)对维持性血液透析(MHD)患者微炎症状态和营养状况的影响。方法选取本院血液净化中心进行MHD的终末期肾病患者68例,按随机原则分为HP+HD组和单纯HD组各34例。HP+HD组每周行HP串联HD治疗1次,单纯HD治疗2次,每周共3次;单纯HD组进行常规HD治疗,每周共3次,两组均连续治疗3个月。分别于治疗前和治疗3个月后采血,检测血超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)、血红蛋白(Hb)、血清白蛋白(Alb)、前白蛋白(Pre-Alb)水平的变化。结果 HP+HD组自身治疗前后相比及与HD组治疗后相比,血hs-CRP、Hcy均明显下降(P<0.05),血Hb、Alb、Pre-Alb均明显上升(P<0.05);HD组较治疗前血hs-CRP、Hcy及Hb、Alb、Pre-Alb均无明显变化(P>0.05)。结论 HP联合HD进行血液净化治疗可有效清除中大分子炎症因子,明显改善MHD患者的微炎症状态及营养状况。Objective To observe influence of hemoperfusion（ HP） combining with hemodialysis（ HD） on microinflammation and nutrition of patients with maintenance hemodialysis. Method Total 68 patients with maintenance hemodialysis admitted to blood purification center of Jishuitan Hospital in Beijing were stochastically divided into two different groups,including HP ＋ HD group with 34 cases and pure HD group with 34 cases. HP ＋ HD group took HP plus HD treatment in series order once a week and pure HD took place twice a week. Total treatment is 3 times per week. Pure HD group took conventional HD 3 times per week. The therapeutic course in both groups are consecutive,lasting for three months. The variance of blood high sensitivity C-reactive protein（ hs-CRP）,homocysteine（ Hcy）,hemoglobin（ Hb）,serum albumin（ Alb） and pre-albumin（ Pre-Alb） before and after three-month treatment were observed and analyzed respectively. Result The outcome from two groups were analyzed and compared after three-month treatment.HP ＋ HD group in hs-CRP and Hcy decreased obviously（ P〈0. 05）,and the condition of Hb,Alb and Pre-Alb were improved significantly（ P〈0. 05）. HD group in hs-CRP,Hcy Hb,Alb and Pre-Alb did not indicate any variance.（ P〉0. 05）. Conclusion HP combining with HD is an effective method to remove increased inflammation factors and to improve microinflammation and nutrition status of patients with maintenance hemodialysis.

关 键 词：血液灌流 血液透析 微炎症 营养 

分 类 号：R459.5[医药卫生—治疗学]