不同透析方式对MHD患者尿毒症毒素清除、炎症因子和氧化应激状态的影响  

Effects of different dialysis methods on uremic toxin clearance,inflammatory factors and oxidative stress in patients undergoing MHD

作　　者：刘绍芳[1] 李金香[1] 陈海燕[1] 赵玉[1] 朱爱华[1] LIU Shaofang;LI Jinxiang;CHEN Haiyan;ZHAO Yu;ZHU Aihua(Department of Emergency,Tangshan People's Hospital,Tangshan,Hebei,China,063001)

机构地区：[1]唐山市人民医院急诊科,河北唐山063001

出　　处：《分子诊断与治疗杂志》2021年第10期1656-1659,1664,共5页Journal of Molecular Diagnostics and Therapy

基　　金：唐山市科学技术研究与发展指导计划(101302113C)。

摘　　要：目的探究不同透析方式对维持性血液透析(MHD)患者尿毒症毒素清除、炎症因子和氧化应激状态的影响。方法选取本院2017年4月至2018年5月100例进行MHD的尿毒症患者为对象,随机分为2组,分别为低通量透析组和高通量透析组,每组各50例,分别应用低通量透析膜以及高通量透析膜血液透析。比较2组患者透析效果、治疗前后血液毒素指标、炎症因子和氧化应激指标变化。结果低通量透析组、高通量透析组透析总有效率分别为78.00%、94.00%,高通量透析组透析总有效率显著高于低通量透析组(P<0.05);2组患者治疗后Scr、BUN、P等毒素指标水平较治疗前显著下降(P<0.05),治疗后高通量透析组患者β_(2)-MG水平显著低于治疗前(P<0.05),而低通量透析组患者β_(2)-MG水平治疗前后差异无统计学意义(P>0.05),治疗后高通量透析组毒素指标水平显著低于低通量透析组(P<0.05);高通量透析组患者治疗后TNF-α、CRP和IL-6等炎症因子水平和SOD、T-AOC和GSH-PX等氧化应激指标较治疗前显著升高(P<0.05),低通量透析组治疗前后炎症因子和氧化应激指标水平差异无统计学意义(P>0.05),高通量透析组炎症因子和氧化应激指标水平高于低通量透析组,差异有统计学意义(P<0.05)。结论尿毒症患者MHD时使用高通量透析方式效果优于低通量透析,其对患者血液毒素清除,炎症因子降低和氧化应激状态改善更为显著。Objective To explore effects of different dialysis methods on uremic toxin clearance,inflammatory factors and oxidative stress in patients undergoing maintenance hemodialysis(MHD).Methods A total of 100 patients with uremia who underwent MHD in the hospital from April 2017 to May 2018 were enrolled.They were randomly divided into 2 groups(low-flux dialysis group and high-flux dialysis group),50 cases in each group.The two groups were treated with low-flux dialysis membranes and high-flux dialysis membrane for hemodialysis,respectively.The dialysis effect,blood toxin indexes,inflammatory factors and changes of oxidative stress indexes before and after treatment were compared between the two groups.Results The total response rate of dialysis in high-flux dialysis group was significantly higher than that in low-flux dialysis group(94.00%vs 78.00%)(P<0.05).The levels of toxins indexes such as Scr,BUN and P were significantly decreased in both groups after treatment(P<0.05).The level ofβ_(2)-MG in the high-flux dialysis group after treatment was significantly lower than that before treatment(P<0.05).The difference was not statistically significant inβ_(2)-MG level of the low-flux dialysis group before and after treatment(P>0.05).The levels of toxin indexes in the high-flux dialysis group were significantly lower than those in the low-flux dialysis group after treatment(P<0.05).The levels of inflammatory factors such as TNF-α,CRP and IL-6,and theoxidative stress indexes such as SOD,T-AOC and GSH-PX in high-flux dialysis group were significantly increased after treatment(P<0.05).The difference was not statistically significant in the inflammatory factors or levels of oxidative stress indexes in the low-flux dialysis group before and after treatment(P>0.05).The inflammatory factors and levels of oxidative stress indexes in the high-flux dialysis group were higher than those in the low-flux dialysis group(P<0.05).Conclusion The effect of high-flux dialysis is better than that of lowflux dialysis for patients with uremi

关 键 词：维持性血液透析 尿毒症 毒素清除 炎症因子 氧化应激 

分 类 号：R692.5[医药卫生—泌尿科学]