血液透析联合血液灌流对糖尿病终末期肾病患者氧化应激和胰岛功能的影响  

Effect of Hemodialysis Combined with Hemoperfusion on Oxidative Stress and Islet Function in Patients with DN-ESRD

作　　者：秦盼盼 陈朝娟 QIN Panpan;CHEN Chaojuan(West China Guang'an Hospital,Sichuan University,Sichuan Guang'an 638500,China)

机构地区：[1]四川大学华西广安医院肾脏内科,四川广安638500

出　　处：《河北医学》2021年第9期1531-1535,共5页Hebei Medicine

基　　金：四川省科技厅资助项目,(编号:20150214207)。

摘　　要：目的:分析血液透析(HD)联合血液灌流(HP)对糖尿病终末期肾病(ESDN)患者氧化应激标志物和胰岛功能的影响。方法:本院治疗的80例糖尿病终末期肾病患者随机对照分为两组,其中只进行血液透析的40例为对照组,进行HD联合HP的40例为研究组。分别于治疗前后采用ELISA试剂盒测定两组治疗前后肾功能标志物[血肌酐(SCr)、尿素氮(BUN)和肾小球滤过率(GFR)],氧化应激标志物[活性氧(ROS)、超氧化物歧化酶(SOD)、丙二醛(MDA)],用稳态模型评估法计算胰岛功能相关指标[胰岛β细胞功能(HOMA-β)、胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(ISI)]水平。结果:治疗前,两组肾功能标志物、氧化应激标志物以及胰岛功能的差异均无统计学意义(P>0.05)。治疗后,两组SCr、BUN、ROS、MDA及HOMA-IR水平均有降低,GFR、SOD、HOMA-β及ISI水平有所升高,且研究组的变化幅度均高于对照组,差异有统计学意义(P<0.05)。结论:血液透析联合血液灌流在减少氧化应激损伤和改善胰岛功能方面的作用优于单纯的血液透析,更加利于改善患者的肾功能。Objective:To analyze the effects of hemodialysis combined with hemoperfusion on oxidative stress markers and islet function in patients with diabetic end-stage renal disease(DN-ESRD).Methods:Totally 80 patients with diabetic end-stage renal disease were randomly divided into two groups.40 patients with HD were made the study group,and 40 patients with HD combined with HP were selected as the control group.The renal function markers[blood creatinine(SCr),urea nitrogen(BUN)and cystic filtration rate(GFR)],oxidative stress markers[reactive oxygen species(ROS),superoxide dismigase(SOD),propylene duedehyde(MDA)]were measured by ELISA Kit before and after treatment in the two groups.The islet function related indicators[insulin resistance index(HOMA-β),insulin resistance index(HOMA-IR)and insulin sensitivity index(ISI)]were calculated by homeostasis model.Results:Before treatment,there was no differences in renal function markers,oxidative stress markers,and islet function between groups(P>0.05).After treatment,the SCr,BUN,ROS,MDA and HOMA-IR levels were reduced in both groups,the GFR,SOD,HOMA-βand ISI levels were increased in both groups,and the change of the study group was higher than the control group,with statistically significant differences(P<0.05).Conclusion:Hemodialysis combined blood irrigation play a better role in reducing oxidative stress damage and improving islet function than hemodialysis alone,which is more effective in improving patients'kidney function.

关 键 词：糖尿病终末期肾病 氧化应激 胰岛功能 血液透析 血液灌流 

分 类 号：R692.5[医药卫生—泌尿科学] R587.1[医药卫生—外科学]