出 处:《广西医学》2021年第21期2554-2558,共5页Guangxi Medical Journal
摘 要:目的观察血液透析联合不同频率血液灌流治疗对行维持性血液透析治疗的尿毒症患者免疫球蛋白、补体C_(3)和C_(4)、炎症因子水平及感染风险的影响。方法将90例行维持性血液透析治疗的尿毒症患者随机分成对照组、低频治疗组和高频治疗组,各30例。所有患者均行普通血液透析治疗,在此基础上,低频治疗组每4周行血液灌流治疗1次,高频治疗组每1周行血液灌流治疗1次。比较治疗前后3组患者免疫球蛋白(IgG、IgA、IgM、IgE)、补体C_(3)和C_(4)、肿瘤坏死因子α(TNF-α)、高敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)、内毒素、铁蛋白水平,以及健康状况调查简表(SF-36)生活质量评分及感染发生率。结果治疗后,低频治疗组、高频治疗组的IgG、IgM、补体C_(3)和C_(4)水平、SF-36生活质量评分均高于对照组及治疗前,TNF-α、hs-CRP、IL-6、内毒素、铁蛋白水平均低于对照组及治疗前(均P<0.05)。治疗后,高频治疗组的IgM、补体C_(3)和C_(4)水平、SF-36生活质量评分高于低频治疗组,TNF-α、hs-CRP、IL-6、内毒素、铁蛋白水平均低于低频治疗组(均P<0.05)。低频治疗组、高频治疗组的感染发生率均低于对照组(P<0.05),但两组间差异无统计学意义(P>0.05)。结论高频率的血液灌流联合血液透析治疗能提高行维持性血液透析治疗的尿毒症患者机体免疫力,减轻患者微炎症状态,降低感染风险,改善生活质量。Objective To observe the effects of hemodialysis combined with hemoperfusion treatment at different frequencies on immunoglobulin,complement C_(3),complement C_(4),inflammatory factor levels,and infection risks in patients with uremia undergoing maintenance hemodialysis treatment.Methods Ninety patients with uremia undergoing maintenance hemodialysis treatment were randomly divided into control group,low-frequency treatment group and high-frequency treatment group,with 30 cases in each group.All patients were treated with conventional hemodialysis,based on which the low-frequency treatment group received hemoperfusion therapy once every four weeks,the high-frequency treatment group received hemoperfusion therapy once a week.The related indices were compared among the three groups before and after the treatment,including the levels of immunoglobulin(IgG,IgA,IgM,IgE),complement C_(3) and C_(4),tumor necrosis factorα(TNF-α),high-sensitivity C-reactive protein(hs-CRP),interleukin 6(IL-6),endotoxin,and ferritin,as well as the 36-Item Short-Form Health Survey(SF-36)scores for quality of life and the incidence rate of infection.Results After the treatment,the low-frequency and high-frequency treatment groups exhibited elevated levels of IgG,IgM,and complement C_(3) and C_(4),higher SF-36 scores for quality of life,and lower levels of TNF-α,hs-CRP,IL-6,endotoxin,and ferritin as compared with the control group and the pre-treatment levels(all P<0.05).After the treatment,the high-frequency treatment group yielded increased levels of IgM,complement C_(3) and C_(4),higher SF-36 scores for quality of life,and lower levels of TNF-α,hs-CRP,IL-6,endotoxin,and ferritin than the low-frequency treatment group(all P<0.05).The incidence rate of infection in the low-frequency and high-frequency treatment groups was lower than that in the control group(P<0.05),whereas there was no statistically significant difference between the low-frequency treatment group and the high-frequency treatment group(P>0.05).Conclusion The combined the
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