不同透析方法对维持性血液透析患者微炎症及内毒素的影响比较  

Comparison on the Influence of Different Dialysis Methods on Maintaining Microinflammation and Endotoxin in Hemodialysis Patients

作　　者：吴强烨 WU Qiangye(Zhongshan Huangpu People's Hospital,Guangdong Province,Zhongshan 528429,China)

机构地区：[1]广东省中山市黄圃人民医院,广东中山528429

出　　处：《中国医学创新》2023年第12期141-144,共4页Medical Innovation of China

基　　金：中山市医学科研项目(2021A020692)。

摘　　要：目的:探究及比较不同透析方法对维持性血液透析患者微炎症及内毒素的影响。方法:将2019年1月-2021年11月中山市黄圃人民医院收治的80例维持性血液透析患者随机分为A组和B组,每组40例。A组进行血液透析(HD)治疗,B组则进行血液透析+血液透析滤过(HD+HDF)治疗。比较两组治疗前及治疗6、12周后的微炎症指标[超敏C反应蛋白(hs-CRP)、血红蛋白(Hb)、白蛋白(ALB)]、小分子毒素[尿素氮(BUN)、血肌酐(Scr)]、中分子毒素[全段甲状旁腺激素(iPTH)、胱抑素C(Cys C)]及大分子毒素[P、β_(2)-微球蛋白(β_(2)-MG)、晚期糖基化终末产物(AGEs)]。结果:治疗前,两组的微炎症指标、小分子毒素、中分子毒素及大分子毒素比较,差异均无统计学意义(P>0.05);治疗6、12周后,两组的微炎症指标、小分子毒素、中分子毒素及大分子毒素均显著改善,且治疗6、12周后,B组的Hb及ALB均显著高于A组,hs-CRP及小分子毒素、中分子毒素、大分子毒素均显著低于A组,差异均有统计学意义(P<0.05)。结论:HD+HDF对维持性血液透析患者微炎症及内毒素的控制效果相对优于HD,在维持性血液透析患者中的应用价值相对更高。Objective:To investigate and compare the influence of different hemodialysis methods for micro-inflammation and endotoxin of patients with maintenance hemodialysis.Method:A total of 80 patients with maintenance hemodialysis in Zhongshan Huangpu People's Hospital from January 2019 to November 2021 were randomly divided into group A and group B with 40 cases in each group.The group A was treated with hemodialysis(HD),the group B was treated with hemodialysis and hemodiafiltration(HD+HDF).Then the microinflammation indices(hs-CRP,Hb,ALB),small molecule toxins(BUN,Scr),medium molecule toxins(iPTH,Cys C)and macromolecule toxins(P,β_(2)-MG,AGEs)of two groups before the treatment and after 6 and 12 weeks of treatment were compared.Result:Before the treatment,the micro-inflammation indexes,small molecule toxins,medium molecule toxins and macromolecular toxins between the two groups were compared,the differences were not statistically significant(P>0.05);after 6 and 12 weeks of treatment,the micro-inflammation indexes,small molecule toxins,medium molecule toxins and macromolecular toxins of the two groups were significantly improved,after 6 and 12 weeks of treatment,the Hb and ALB of group B were significantly higher than those of group A,the hs-CRP,small molecule toxins,medium molecule toxins and macromolecular toxins were significantly lower than those of group A,the differences were statistically significant(P<0.05).Conclusion:The control effect of HD+HDF for micro-inflammation and endotoxin of patients with maintenance hemodialysis are relatively better than those of HD,so its application value in the patients with maintenance hemodialysis is relatively higher.

关 键 词：血液透析滤过 血液透析 维持性血液透析 微炎症 内毒素 

分 类 号：R692.5[医药卫生—泌尿科学]