血液透析与腹膜透析对终末期肾病患者血脂、氧化应激及炎症因子的影响  

Effects of Hemodialysis and Peritoneal Dialysis on Blood Lipids,Oxidative Stress and Inflammatory Factors in Patients with End-stage Renal Disease

作　　者：朱雪丽 苏东美 任文 温月[1] ZHUXue-li;SU Dong-mei;REN Wen;WEN Yue(Department of Nephrology,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院肾内科,四川成都610041

出　　处：《标记免疫分析与临床》2019年第3期371-375,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的分析血液透析与腹膜透析对终末期肾病(ESRD)患者血脂、氧化应激及炎症因子的影响。方法选取2016年1月至2018年1月我院收治的终末期肾病患者200例为研究对象,采用随机数字表法将其分为观察组、对照组各100例,对照组予以血液透析治疗,观察组实施腹膜透析治疗,比较两组治疗前后血脂[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)]、氧化应激指标[丙二醛(MDA)、髓过氧化物酶(MPO)、超氧化物歧化酶(SOD)]、炎症因子[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)]水平、生存质量[健康状况调查简表(SF-36)]及并发症的情况。结果治疗后观察组血清TC、TG、HDL-C、LDL-C水平明显低于对照组(P <0.05);治疗后观察组血清MDA、MPO、hs-CRP、TNF-α、IL-6水平低于对照组,而SOD水平高于对照组(P <0.05);治疗3个月、治疗6个月观察组SF-36评分高于对照组(P <0.05);观察组治疗期间并发症发生率12.0%低于对照组24. 0%(P <0.05)。结论与血液透析相比,腹膜透析治疗ESRD疗效更好,可明显改善患者血脂、氧化应激及炎症因子水平,提高其生活质量,减少并发症,值得在临床推广实践。Objective To analyze the effects of hemodialysis and peritoneal dialysis on serum lipids,oxidative stress and inflammatory factors in patients with end-stage renal disease(ESRD).Methods A total of 200 patients with ESRD who were admitted to the hospital during the period from January 2016 to January 2018 were enrolled in the study.They were randomly divided into the observation group and the control group,with 100 patients in each.The control group was treated with hemodialysis while the observation group was treated with peritoneal dialysis.The levels of blood lipids[total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C)],oxidation indications[malondialdehyde(MDA),myeloperoxidase(MPO),superoxide dismutase(SOD)]and inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],as well as the quality of life[short from health survey(SF-36)]and the incidence of complications were compared between the two groups.Results The levels of serum TC,TG,HDL-C and LDL-C in the observation group were significantly lower than those in the control group(P<0.05).The levels of serum MDA,MPO,hs-CRP,TNF-αand IL-6 in the observation group were lower than those in the control group while the level of SOD was higher than that in the control group(P<0.05).The SF-36 scores of the observation group were higher than those of the control group after 3 months and 6 months of treatment(P<0.05).The incidence of complications in the observation group during the treatment was lower than that in the control group(12.00%vs 24.00%)(P<0.05).Conclusion Compared with hemodialysis,the curative effect of peritoneal dialysis on ESRD is better.The latter can significantly improve the levels of blood lipids,oxidative stress and inflammatory factors,improve the quality of life of patients and reduce complications.

关 键 词：血液透析 腹膜透析 终末期肾病 血脂 氧化应激 炎症因子 影响 

分 类 号：R692.5[医药卫生—泌尿科学]