血液透析加血液灌流对终末期糖尿病肾病患者骨密度以及anti-ox-LDL-Ab水平的影响  

Effect of hemodialysis plus hemoperfusion on bone mineral density and anti-ox-LDL-Ab level in patients with kidney disease

作　　者：韦振忠 宋雪霞[2] 廖红霞 王培燃 谭鹤长[2] WEI Zhenzhong;SONG Xuexia;LIAO Hongxia;WANG Peiran;TAN Hechang(Department of Hemodialysis,The Second Affiliated Hospital of Guangxi University of Science and Technology,Guangxi,Liuzhou 545006,China)

机构地区：[1]广西科技大学第二附属医院内一科血透室,柳州545006 [2]广西医科大学第四附属医院肾内科,柳州545005

出　　处：《疑难病杂志》2018年第9期900-904,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：国家自然科学基金项目(81660122);广西壮族自治区卫计委科学研究项目(Z2016164)

摘　　要：目的 观察血液透析加血液灌流对终末期糖尿病肾病患者骨密度以及抗氧化低密度脂蛋白抗体(anti-ox-LDL-Ab)水平的影响,为其血液透析选择提供参考。方法 选择2016年5月—2017年12月广西科技大学第二附属医院内一科血透室收治的终末期糖尿病肾病患者106例作为研究对象,随机数字表法分为对照组和观察组,各53例。对照组患者给予血液透析治疗,观察组患者给予血液透析加血液灌流治疗,治疗4周后比较2组患者治疗前后炎性因子、脂质过氧化水平、指骨骨密度及肾功能指标变化,同时分析2组患者治疗前后生活质量评分。结果 2组患者治疗前脂质过氧化水平(anti-ox-LDL-Ab、MDA、LOOH)、炎性因子(hs-CRP、HCY、PCT)、骨密度(BMD)、肾功能指标(SCr、BUN、GFR)以及生活质量评分(KPS、HAMD评分)比较,差异均无统计学意义(P>0.05)。与治疗前比较,2组患者治疗4周后anti-ox-LDL-Ab、MDA、LOOH、hs-CRP、Hcy、PCT、SCr、BUN水平以及HAMD评分均显著降低,而BMD、GFR水平以及KPS评分均显著升高,且观察组较对照组改善更明显,差异均有统计学意义(t/P=5.465/0.000、6.059/0.000、6.151/0.000、9.680/0.000、9.698/0.000、18.155/0.000、6.268/0.000、14.658/0.000、7.240/0.000、3.640/0.000、5.239/0.000、6.686/0.000)。结论 血液透析加血液灌流可以更好地恢复ESDN患者的肾功能,减轻微炎性反应,从而提高骨密度,改善体内脂质的过氧化状态。Objective To investigate the effect of hemodialysis plus hemoperfusion on bone mineral density and anti-ox-LDL-Ab levels in patients with kidney disease,and provide reference for hemodialysis patients with end-stage diabetic nephropathy. Methods Sixty-six patients with end-stage diabetic nephropathy treated in the hospital from May 2016 to December 2017 were randomly divided into control group and observation group, with 53 cases in each group, the patients in the control group were given hemodialysis treatment. The patients in the observation group were given hemodialysis plus hemoperfusion. The bone mineral density,micro-inflammatory state,lipid peroxidation, and changes in renal function were compared between the two groups before and after treatment. At the same time, the changes of quality of life scores before and after treatment in both groups were analyzed. Results There was no statistically significant difference in lipid peroxidation（anti-ox-LDL-Ab, MDA, LOOH）, micro-inflammation（hs-CRP, HCY, PCT）, bone mineral density（BMD）, renal function（SCr, BUN, GFR）, and quality of life scores （KPS, HAMD score）before treatment between the two groups （ t/P =0.080/ 0.468 , t/P =0.289/0.387, t/P =0.172/0.432, t/P =0.815/0.208, t/P =1.001/0.160, t/P =0.504/0.308, t/P =0.932/ 0.177 , t/P =0.482/0.315, t/P =0.389/0.349, t/P =0.562/0.288, t/P =0.923/0.179, t/P =0.429/0.334）. Compared with the control group, the anti-ox-LDL-Ab, MDA, LOOH, s-CRP, HCY, PCT, SCr, BUN levels and HAMD scores were significantly lower in the observation group, the BMD, GFR levels and KPS scores were significantly higher,and the difference was statistically significant （ t/P =5.465/0.000, t/P =6.059/0.000, t/P =6.151/0.000, t/P =9.680/0.000, t/P =9.698/0.000, t/P =18.155/0.000, t/P =6.268/0.000, t/P =14.658/0.000, t/P =7.240/0.000, t/P =3.640/0.000, t/P =5.239/0.000, t/P =6.686/0.000）. Conclusion Hemodialysis combined with hemoperfusion can better restore the renal function of ESDN patients, reduce the micro-inflamm

关 键 词：血液透析 血液灌流 糖尿病肾病 骨密度 抗氧化低密度脂蛋白抗体 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]