不同血液透析模式对纠正维持性透析患者微炎症状态的疗效对比  

Comparison of Therapeutic Effect of Different Hemodialysis Modes on Correcting Microinflammatory State in Maintenance Dialysis Patients

作　　者：姜晓岚[1] 孙继梅[1] 白帆[1] 孙艳玲[1] 刘斌[1] JIANG Xiaolan;SUN Jimei;BAI Fan;SUN Yanling;LIU Bin(Department of Nephrology,Kunming First People's Hospital,Kunming,Yunnan Province,650011 China)

机构地区：[1]昆明市第一人民医院肾内科,云南昆明650011

出　　处：《系统医学》2023年第1期134-137,150,共5页Systems Medicine

基　　金：昆明市卫生健康委员会(2020-03-05-001)。

摘　　要：目的分析对比不同血液透析模式对纠正维持性透析患者微炎症状态的疗效。方法选取2018年3月—2020年1月于昆明市第一人民医院行维持性血液净化治疗的慢性肾脏病5期患者60例,按照随机表法分为高通组和低通组,各30例。高通组患者采用高通量血液透析,低通组患者采用低通量血液透析,观察比较两组患者治疗前、治疗6个月、12个月、18个月的超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平。比较两组治疗18个月后的两组残余肾功能、血钙、磷、甲状旁腺激素水平。结果高通组患者治疗18个月的血IL-6[(13.98±4.63)mmol/L]、TNF-α[(21.76±8.44)mmol/L]、血磷[(1.38±0.32)mmol/L]、iPTH[(302±116)pg/mL]水平明显低于低通组,差异有统计学意义(t=8.539、15.866、2.598、3.403,P<0.05);高通组患者的残余肾功能(1.09±0.35)mL/min明显优于低通组,差异有统计学意义(t=3.981,P<0.05)。结论高通量血液透析能纠正终末期肾脏病患者体内的微炎症状态,改善患者的残余肾功能,可促进血磷、PTH的清除,具有一定的治疗优势。Objective To analyze and compare the effect of different hemodialysis modes on correcting microinflamma⁃tory state in maintenance dialysis patients.Methods 60 with stage 5 chronic kidney disease who received mainte⁃nance blood purification treatment in Kunming First People's Hospital from March 2018 to January 2020 were se⁃lected,and divided into high pass group and low pass group according to random table method,with 30 cases in each group.Patients in high pass group received high-flux hemodialysis,and patients in low pass group received low-flux hemodialysis.The levels of hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6)and tumor necrosis fac⁃tor-α(TNF-α)were observed and compared in all groups before,6,12 and 18 months after treatment.Residual renal function,blood calcium,phosphorus and parathyroid hormone levels between two groups were compared after 18 months of treatment.Results After 18 months of treatment,the levels of IL-6[(13.98±4.63)mmol/L],TNF-α[(21.76±8.44)mmol/L],phosphorus[(1.38±0.32)mmol/L]and iPTH[(302±116)pg/mL]in high pass group were significantly lower than those in low pass group,the difference was statistically significant(t=8.539、15.866、2.598、3.403,P<0.05);the residual renal function(1.09±0.35)mL/min in high pass group was significantly better than that in low pass group,and the difference was statistically significant(t=3.981,P<0.05).Conclusion High-flux hemodialysis can cor⁃rect the microinflammatory state in patients with end-stage renal disease,improve the residual renal function of patients,and promote the clearance of blood phosphorus and PTH,which has certain therapeutic advantages.

关 键 词：维持性血液透析 微炎症 肾功能 高通量 

分 类 号：R692.5[医药卫生—泌尿科学]