血液灌流联合序贯透析治疗老年终末期糖尿病肾病对患者血清sTNFERⅠ、sTNFERⅡ水平及胰岛素抵抗的影响  

Effects of Hemoperfusion Combined with Sequential Dialysis on Levels of Serum sTNFERⅠ,sTNFERⅡand Insulin Resistance in Elderly Patients with End-stage Diabetic Nephropathy

作　　者：张祥芳 ZHANG Xiang-fang(Department of Endocrinology,Hongze District People′s Hospital,Huai'an 223100,China)

机构地区：[1]江苏省淮安市洪泽区人民医院内分泌科,江苏淮安223100

出　　处：《药物生物技术》2022年第5期489-493,共5页Pharmaceutical Biotechnology

摘　　要：探究血液灌流联合序贯透析治疗老年终末期糖尿病肾病对患者血清可溶性肿瘤坏死因子受体Ⅰ(sTNFERⅠ)、可溶性肿瘤坏死因子受体Ⅱ(sTNFERⅡ)水平及胰岛素抵抗(IR)的影响。收集2018年5月至2020年1月江苏省淮安市洪泽区人民医院内分泌科收治的106例老年终末期糖尿病肾病患者,根据随机数字表法分为观察组和对照组,各53例。对照组采用血液透析进行治疗,观察组采用血液灌流联合序贯透析进行治疗,两组均治疗3个月。比较两组治疗前、治疗3个月后血清sTNFRⅠ、sTNFRⅡ及肿瘤坏死因子-α(TNF-α)水平、IR、肾功能及氧化应激指标水平。治疗3个月后,两组血清sTNFRⅠ、sTNFRⅡ、TNF-α、空腹血糖(FPG)、空腹胰岛素(FINS)、稳态模型胰岛素抵抗指数(HOMA-IR)、丙二醛(MDA)、晚期蛋白氧化产物(AOPPs)及血肌酐(Scr)、血尿素氮(BUN)水平较治疗前降低,观察组低于对照组,差异具有统计学意义(P<0.05)。治疗3个月后,两组全血肾小球滤过率(GFR)、血清超氧化物歧化酶(SOD)水平较治疗前升高,观察组高于对照组,差异具有统计学意义(P<0.05)。血液灌流联合序贯透析可降低老年终末期糖尿病肾病患者血清sTNFERⅠ、sTNFERⅡ水平,减轻机体病理损伤,抑制氧化应激及IR,改善肾功能。To explore the effects of hemoperfusion combined with sequential dialysis on levels of serum soluble tumor necrosis factor receptor I(sTNFER I),soluble tumor necrosis factor receptor II(sTNFER II)and insulin resistance(IR)in elderly patients with end-stage diabetic nephropathy,106 elderly patients with end-stage diabetic nephropathy admitted to the department of endocrinology,hongze district people′s hospital between May 2018 and January 2020 were collected and divided into the observation group and the control group according to the random number table method,with 53 cases in each groups.The control group was treated with hemodialysis,while the observation group was treated with hemoperfusion combined with sequential dialysis.Both groups were treated for 3 months.The serum level of sTNFR I,sTNFR II,tumor necrosis factor-α(TNF-α),IR,renal function,and level of oxidative stress before and after 3 months of treatment of two groups were compared.After 3 months of treatment,the two groups of serum levels of sTNFR I,sTNFR II,TNF-α,fasting blood glucose(FPG),fasting insulin(FINS),homeostatic model insulin resistance index(HOMA-IR),malondialdehyde(MDA),late protein Oxidation products(AOPPs),blood creatinine(Scr)and blood urea nitrogen(BUN)were lower than before treatment,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).After 3 months of treatment,the levels of whole blood glomerular filtration rate(GFR)and serum superoxide dismutase(SOD)of the two groups were higher than before treatment,and the observation group was higher than the control group,the difference was statistically significant(P<0.05).The hemoperfusion combined sequential dialysis could decrease the serum levels of sTNFER I,sTNFER II of elderly patients with end-stage diabetic nephropathy,reduce the body′s pathological damage,inhibit oxidative stress and IR,and improve renal function.

关 键 词：糖尿病肾病 终末期 老年 血液灌流 血液透析 可溶性肿瘤坏死因子受体Ⅰ 可溶性肿瘤坏死因子受体Ⅱ 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]