不同通量透析膜对维持性血液透析患者氧化应激状态及血清炎症因子的影响  

Influence of high-flux and low-flux dialysis membranes on oxidative stress and serum inflammatory factors in patients with maintenance hemodialysis

作　　者：李文静[1] 史聪 宋培[1] 王天智[1] 刘翠红[1] LI Wen-jing;SHI Cong;SONG Pei;WANG Tian-zhi;LIU Cui-hong(Department of Nephrology , Shijiazhuang the Third Hospital, Shijiazhuang , Hebei 050000, Chin)

机构地区：[1]河北省石家庄市第三医院肾内科,河北石家庄050000

出　　处：《中国临床研究》2018年第4期486-489,493,共5页Chinese Journal of Clinical Research

基　　金：石家庄市科学技术研究与发展指导计划(151460973)

摘　　要：目的探讨高通量透析膜和低通量透析膜对维持性血液透析(MHD)患者氧化应激状态及血清炎症因子的影响。方法选择2016年8月至2017年3月接受治疗的136例MHD患者为研究对象,按随机数字表法将其分为对照组与观察组,每组68例。对照组给予低通量透析膜血液透析,观察组给予高通量透析膜血液透析,治疗28周。检测两组治疗前后的血液毒素指标[尿素氮(BUN)、血肌酐(Scr)、血磷(P)、β_2微球蛋白(β_2-MG)]水平,氧化应激状态指标[丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)、总抗氧化能力(TAOC)]水平及炎症反应指标[C反应蛋白(CRP)、肿瘤细胞坏死因子(TNF)-α、白细胞介素(IL)-6]水平,并评定两组治疗后临床疗效。结果治疗后,观察组临床总有效率为92.65%,高于对照组的70.59%(χ2=11.027,P<0.01)。与治疗前相比,观察组治疗后BUN、Scr、P、β_2-MG、MDA、CRP、TNF-α、IL-6水平均降低,而SOD、GSH-PX、TAOC水平均升高,差异具有统计学意义(P均<0.01)。与治疗前比,对照组治疗后β_2-MG及T-AOC水平比较差异无统计学意义(P均>0.05);而BUN、Scr、P、SOD、GSH-PX水平均降低,MDA、CRP、TNF-α、IL-6水平均升高,差异具有统计学意义(P均<0.01)。治疗后,观察组与对照组相比,BUN、Scr、P、β_2-MG、MDA、CRP、TNF-α、IL-6水平降低,SOD、GSH-PX、T-AOC水平均升高,差异具有统计学意义(P均<0.01)。结论采用高通量透析膜对MHD患者进行血液透析,能有效清除患者血液毒素,提高机体抗氧化能力,并降低氧化应激及炎症反应。Objective To explore the influences of high-flux and low-flux dialysis membranes on oxidative stress and serum inflammatory factors in patients with maintenance hemodialysis（MHD）. Methods A total of 136 MDH patients treated from August 2016 to March 2017 were selected as study objects and were randomly divided into control group（low flux dialysis membrane） and observation group（high flux dialysis membranes）（n = 68,each）. All patients were treated for28 weeks. The following indicators were detected before and after treatment：（1） Blood levels of toxin index including urea nitrogen（BUN）,creatinine（Scr） and phosphorus（P）,β2 microglobulin（β2-MG）;（2） Oxidative stress index including malondialdehyde（MDA）,superoxide dismutase（SOD）,glutathione peroxidase（GSH-PX）,total antioxidant capacity（TAOC）;（3） Inflammatory reaction index of C reactive protein（CRP）,tumor necrosis factor α（TNF-α） and interleukin 6（IL-6）. The clinical efficacy was evaluated between two groups at 28 weeks after treatment. Results After treatment,the total effective rate in observation group was significantly higher than that in control group（92. 65% vs 70. 59%,χ2=11. 027,P〈0. 01）. Compared with pre-treatment,the levels of BUN,Scr,P,β2-MG,MDA,CRP,TNF-α and IL-6 significantly decreased,and the levels of SOD,GSH-PX and T-AOC increased after treatment in observation group（all P〈0. 01）. In control group,there was no significant difference in the levels of β2-MG and T-AOC between pre-treatment and post-treatment（all P〈0. 05）,however,the levels of BUN,Scr,P,SOD and GSH-PX significantly decreased,and the levels of MDA and CRP,TNF-α,IL-6 increased after treatment compared with pre-treatment（all P〈0. 01）. After treatment,the levels of BUN,Scr,P,β2-MG,MDA,CRP,TNF-α and IL-6 significantly decreased,and the levels of SOD,GSH-PX and TAOC significantly increased in observation group compared with control group（all P〈0. 01）. Conclusion High flux dialysis me

关 键 词：透析膜 高通量 低通量 血液透析 维持性 氧化应激 炎症因子 血液毒素 

分 类 号：R459.5[医药卫生—治疗学]