超纯透析液联合高通量透析治疗对终末期肾病MHD患者氧化应激、微炎症状态和钙磷代谢的影响  

Effects of ultra-pure dialysate combined with high flux dialysis on oxidative stress,microinflammatory state and calcium-phosphorus metabolism in patients with end-stage renal disease undergoing MHD

作　　者：张健[1] 杨颖嘉[1] 王丰平 丁琦[1] ZHANG Jian;YANG Ying-jia;WANG Feng-ping;DING Qi(Department of Nephrology,the Second People′s Hospital of Chengdu City,Sichuan Province,Chengdu 610017,China)

机构地区：[1]四川省成都市第二人民医院肾病内科,四川成都610017

出　　处：《河北医科大学学报》2024年第12期1399-1403,共5页Journal of Hebei Medical University

基　　金：四川省科技计划项目(2019YFS0445)。

摘　　要：目的探讨超纯透析液联合高通量透析治疗对终末期肾病维持性血液透析(maintenance hemodialysis,MHD)患者氧化应激、微炎症状态和钙磷代谢的影响。方法回顾性分析我院收治的终末期肾病MHD患者120例临床资料,根据透析方式不同分为超纯透析液组(n=60)和非超纯透析液组(n=60),其中非超纯透析液组采用常规透析液,超纯透析液组透析液以超纯水+中心供液提供浓缩A液+B粉筒配置。均进行高通量透析,比较2组治疗后的血清氧化应激指标[丙二醛(malondialdehyde,MDA)、谷胱甘肽过氧化酶(glutathione peroxidase,GSH-px)]、微炎症状态[白细胞介素6(interleukin-6,IL-6)、白细胞介素13(interleukin-13,IL-13)、C反应蛋白(C-reactionprotein,CRP)、白蛋白(albumin,ALB)、血红蛋白(hemoglobin,Hb)、血细胞比容(hematocrit,HCT)]、肾功能指标[尿素氮(blood urea nitrogen,BUN)、肌酐(serum creatinine,SCr)、β2微球蛋白(β2 microglobulin,β2-MG)、肾小球滤过率(estimated glomerular filtration rate,eGFR)]及钙磷代谢情况。结果治疗后,2组MDA、IL-6、CRP、ALB、Hb、HCT及血钙水平均显著升高(P<0.05),GSH-px、IL-13、BUN、SCr、β2-MG、eGFR及血磷、钙磷乘积水平均显著降低(P<0.05),且超纯透析液组上述指标除ALB、HCT外与非超纯透析液组差异均有统计学意义(P<0.05)。结论超纯透析液联合高通量透析治疗能有效改善终末期肾病MHD患者体内氧化应激反应及微炎症状态,利于稳定钙磷代谢平衡,延缓残肾功能丢失,值得临床推广应用。Objective To observe and explore the effects of ultra-pure dialysate combined with high flux dialysis on oxidative stress,microinflammatory state and calcium-phosphorus metabolism in patients with end-stage renal disease(ESRD)undergoing maintenance hemodialysis(MHD).Methods Clinical data of 120 patients with ESRD undergoing MHD who were treated in our hospital were retrospectively analyzed,and the patients were divided into ultra-pure dialysate group(n=60)and non-ultra-pure dialysate group(n=60)according to different dialysis methods.The non-ultra-pure dialysate group received conventional dialysate,and the ultra-pure dialysate group received ultra-pure water+central liquid supply of concentrated A solution+B powder cylinder configuration.All patients underwent high flux dialysis.Serum oxidative stress indicators[malondialdehyde(MDA),glutathione peroxidase(GSH-px)],microinflammatory state[interleukin-6(IL-6),interleukin-13(IL-13),C-reactive protein(CRP),albumin(ALB),hemoglobin(Hb),hematocrit(HCT)],renal function indicators[blood urea nitrogen(BUN),serum creatinine(SCr),β2 microglobulin(β2-MG),estimated glomerular filtration rate(eGFR)]and calcium-phosphorus metabolism were compared between the two groups after treatment.Results After treatment,the levels of MDA,IL-6,CRP,ALB,Hb,HCT and blood calcium in both groups were significantly increased(P<0.05),while the levels of GSH-px,IL-13,BUN,SCr,β2-MG,eGFR,blood phosphorus and calcium-phosphorus product were significantly decreased(P<0.05),and the above indicators except ALB and HCT were significantly different between ultra-pure dialysate group and non-ultra-pure dialysate group(P<0.05).Conclusion Ultra-pure dialysate combined with high flux dialysis can effectively improve the body′s oxidative stress response and microinflammatory state,help stabilize the balance of calcium-phosphorus metabolism and delay the loss of residual kidney function in patients with ESRD undergoing MHD,and it is worthy of clinical promotion and application.

关 键 词：肾功能衰竭 慢性 超纯透析液 高通量透析 

分 类 号：R692.5[医药卫生—泌尿科学]