高通量和低通量血液透析对尿毒症患者体内毒副代谢产物及细胞因子的影响  

Effect of high-flux and low-flux hemodialysis on the side metabolites and cytokines in patients with uremia

作　　者：高萍[1] 马金荣[1] 赵丽[1] 裴国超[1] 石国娟[1] 李莉[1] 

机构地区：[1]河北省沧州中西医结合医院肾病科,河北沧州061001

出　　处：《海南医学院学报》2017年第6期773-775,778,共4页Journal of Hainan Medical University

基　　金：河北省重点科技攻关基金资助项目(05463)~~

摘　　要：目的:研究高通量和低通量血液透析对尿毒症患者体内毒副代谢产物及细胞因子的影响。方法:选择在我院接受高通量血液透析治疗的50例尿毒症患者和接受低通量血液透析治疗的140例尿毒症患者分别作为高通量组和低通量组。透析前和透析后分别采集血清,测定毒副代谢产物、钙磷代谢指标以及细胞因子的含量。结果:透析后3个月时,两组血清中Ca含量与透析前比较无显著性差异,BUN、Scr、β2-MG、sTfR、P、PTH、AKP的含量均显著低于透析前;透析后3个月时,高通量组血清中BUN、Scr、Ca的含量与低通量组比较无显著性差异,β2-MG、sTfR、P、PTH、AKP、TNF-α、IL-1β、IL-6、IL-8、IL-10的含量显著低于低通量组。结论:与低通量血液透析相比较,高通量血液透析治疗尿毒症能够更为有效地清除中分子、大分子毒素的清除效果并纠正钙磷代谢紊乱、减轻微炎症状态。Objective： To study the effects of high-flux and low-flux hemodialysis on the side metabolites and cytokines in patients with uremia. Methods： A total of 50 patients with uremia who accepted high-flux hemodialysis and 140 patients with uremia who accepted low-flux hemodialysis in our hospital between March 2015 and March 2016 were selected and included in high-flux group and low-flux group respectively. Before and after dialysis, serum was collected respectively to determine the levels of side metabolites, calcium-phosphorus metabolism indexes and eytokines. Results： Three months after dialysis, serum Ca levels of two groups of patients were not significantly different from those before dialysis while BUN, Scr, β2-MG, sTfR, P, PTH and AKP levels were significantly lower than those before dialysis. Three months after dialysis, serum BUN, Scr and Ca levels of high-flux group were not significantly different from those of low-flux group while β2-MG, sTfR, P, PTH, AKP, TNF-α, IL-1β, IL-6, IL-8 and IL-10 levels were significantly lower than those of low-flux group. Conclusion： Compared with low-flux hemodialysis, high-flux hemodialysis treatment of uremia can more effectively remove middle molecular and macromolecular toxins, correct calcium-phosphorus metabolism disorder and relieve micro-inflammatory state.

关 键 词：尿毒症 高通量血液透析 代谢产物 甲状旁腺激素 炎性因子 

分 类 号：R692[医药卫生—泌尿科学]