结肠透析对CRF患者炎症、营养状态及Hcy、β_2-MG的影响  

Effects of colon dialysis on inflammation, nutritional status, Hcy, and β_2 MG in patients with chronic renal failure

作　　者：丁笑 成梅初[1] 周乐天[1] 杨大业 DING Xiao;CHENG Meichu;ZHOU Letian(Department of Nephrology,The Second Xiangya Hospital of Central South University,Hunan,Changsha 410011,China)

机构地区：[1]中南大学湘雅二医院肾内科,长沙市410011

出　　处：《河北医药》2019年第5期749-751,755,共4页Hebei Medical Journal

摘　　要：目的探讨结肠透析对慢性肾衰竭(CRF)患者炎症、营养状态及同型半胱氨酸(Hcy)、β_2-微球蛋白(β_2-MG)的影响。方法选取2016年2月至2017年11月接受治疗的CRF患者104例,根据患者最终选取的治疗方式分为观察组(n=49)和对照组(n=55)。对照组给予常规对症治疗,观察组在对照组治疗基础上加用结肠透析,检测2组治疗前后肾功能、营养状态、炎性因子及Hcy、β_2-MG水平。结果观察组治疗后血肌酐(Scr)和血尿酸氮(BUN)明显低于对照组(P<0.05);观察组治疗后白蛋白(Alb)和血清前白蛋白(PA)明显高于对照组(P<0.05);观察组和对照组治疗前后上臂围、上臂肌围和肱三头肌皮褶厚度厚度比较差异无统计学意义(P>0.05);观察组治疗后Hcy、β_2-MG、白介素-6(IL-6)和超敏C-反应蛋白(hs-CRP)明显低于对照组(P<0.05)。结论联合结肠透析治疗可改善CRF患者炎症和营养状态,延缓肾衰竭的进展,降低心血管疾病相关蛋白Hcy和β_2-MG水平,值得研究。Objective To investigate the effects of colon dialysis on inflammation,nutritional status,homocysteine(Hcy),andβ2 microglobulin(β2-MG)in patients with chronic renal failure(CRF).Methods A total of 104 patients with CRF who were treated in our hospital from February 2016 to November 2017 were selected as subjects.According to the patient's final choice of treatment,they were divided into the observation group(n=49)and control group(n=55).The patients in control group were given conventional symptomatic treatment,however,the patients in observation group,on the basis of control group,were treated by colon dialysis.The renal function,nutritional status,inflammation factors and the levels of Hcy andβ2-MG before and after treatment were observed and compared between the two groups.Results After treatment the serum levels of creatinine(Scr)and blood uric acid nitrogen(BUN)in observation group were(330.21±38.82)μmol/L and(16.05±5.22)mmol/L,respectively,which were significantly lower than those in control group(P<0.05).Moreover after treatment the levels of albumin(Alb)and serum prealbumin(PA)were(46.22±5.89)g/L and(420.05±50.01)g/L,respectively,which were significantly higher than those in control group(P<0.05).However there were no significant differences in biceps circumference,arm muscle circumference and triceps skinfold thickness between the two groups before and after treatment(P>0.05).After treatment the levels of Hcy,β2-MG,interleukin 6(IL-6)and high sensitive C reactive protein(hs CRP)in observation group which were(1.65±1.21)mg/L,(7.20±1.05)mg/L,(1.30±0.36)mg/L and(5.82±1.03)pg/ml,respectively,which were significantly lower than those in control group(P<0.05).Conclusion The combination colon dialysis treatment can improve the inflammation and nutritional status in patients with CRF,delay the progression of renal failure,reduce the levels of cardiovascular disease related protein including Hcy andβ2-MG,which is worth being researched further.

关 键 词：慢性肾衰竭 同型半胱氨酸 Β2-微球蛋白 营养状态 炎性因子 

分 类 号：R459.5[医药卫生—治疗学]