不同血液净化方式对尿毒症患者肌生长抑制素、炎性介质水平影响的研究  

Effects of Different Blood Purification Methods on the Levels of Myostatin and Inflammatory Mediators in Uremic Patients

作　　者：黄巍 孙艺[1] 郑华[1] HUANG Wei;SUN Yi;ZHENG Hua(Central Hospital Affi liated to Shenyang Medical College,Shenyang 110024,China)

机构地区：[1]沈阳医学院附属中心医院,辽宁沈阳110024

出　　处：《中国医药指南》2020年第10期39-41,共3页Guide of China Medicine

基　　金：沈阳医学院科学研究基金(20171009)。

摘　　要：目的通过比较血液透析(HD)与血液透析+血液灌流(HD+HP)对尿毒症患者肌生长抑制素、炎性介质水平的影响,为尿毒症维持性血液透析(MHD)患者延缓骨骼肌萎缩、改善其肌力提供临床依据。方法选取MHD患者40例,随机分为实验组及对照组,每组20例,实验组:HD 3次/周,联合HP 1次/周。对照组:HD 3次/周。按照上述方式治疗4周。测定并比较两组治疗前后血红蛋白(Hb)、白蛋白(Alb)、血肌酐(SCr)、尿素氮(BUN)、肌生长抑制素(MSTN)、白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)水平。结果实验组治疗后MSTN、IL-6、TNF-α水平均较治疗前显著降低(P<0.05);对照组治疗后MSTN、IL-6、TNF-α水平与治疗前比较,差异无统计学意义(P>0.05)。实验组与对照组Hb、Alb水平与自身治疗前比较,差异无统计学意义(P>0.05)。实验组与对照组SCr、BUN水平均较自身治疗前显著下降(P<0.05)。结论HD+HP能够清除尿毒症患者MSTN、IL-6、TNF-α,且效果优于HD。Objective The aim of the present study was to observe the effects of hemodialysis(HD)and hemoperfusion(HP)combining with hemodialysis(HD)on myostatin and inflammatory mediators levels in uremic patients,and provide a clinical basis to delay skeletal muscle atrophy and improve muscle strength in uremia patients with maintenance hemodialysis(MHD).Methods Forty MHD patients with hyperphosphatemia were randomly divided into two groups,20 cases in each group.Experimental Group(HP+HD)took HP+HD treatment once a week and pure HD took place three times a week.Contral group(HD)took conventional HD 3 times per week.The therapeutic course in both groups were lasting for four weeks.Serum MSTN,IL-6,TNF-α,Hb、Alb,Scr and BUN levels were measured prior to and following treatment.Results The levels of MSTN,IL-6 and TNF-αin the experimental group were significantly lower than those before treatment(P<0.05).The levels of MSTN,IL-6 and TNF-αin the control group were not significantly different from those before treatment(P>0.05).There was no significant difference in the levels of Hb and Alb between the experimental group and the control group before treatment(P>0.05).The levels of SCr and BUN in the experimental group and the control group were signifi cantly lower than those before treatment(P<0.05).Conclusion HP combining with HD is an effective method for clearing MSTN,IL-6 and TNF-αin uremic patients,and the ef fect is better than HD.

关 键 词：尿毒性 血液净化 肌生长抑制素 炎性介质 

分 类 号：R692.5[医药卫生—泌尿科学]