不同血液净化方式对尿毒症患者炎症因子、肠道菌群的影响分析  

Analysis on Effects of Different Blood Purification Methods on Inflammatory Factors and Intestinal Flora in Patients with Uremia

作　　者：李逸群 祝艳丽 LI Yiqun;ZHU Yanli(Dingxi ci People's Hospital,Dingxi City,Gansu Province,China 743000)

机构地区：[1]定西市人民医院,甘肃定西743000

出　　处：《卫生职业教育》2025年第6期142-145,共4页HEALTH VOCATIONAL EDUCATION

摘　　要：目的深入分析不同血液净化方式对尿毒症患者炎症因子、肠道菌群结构水平影响的具体作用,并探讨它们之间的潜在联系。方法选取2022年1月—2024年1月在定西市人民医院血液净化中心接受维持性血液透析(MHD)治疗的90例尿毒症患者作为研究对象,根据血液净化方式的不同将患者分为3组:A组(血液透析,n=28)、B组(血液透析+血液透析滤过,n=30)、C组(血液透析+血液透析滤过+血液灌流,n=32),采用PCR方法测定3组尿毒症患者粪便中的大肠杆菌、粪肠球菌、嗜酸乳酸杆菌、双歧杆菌的含量;采用ELISA法测定3组尿毒症患者TNF-α、hs-CRP、IL-6的水平;通过Pearson相关分析,探讨肠道菌群与微炎症因子的相关性。结果透析后,hs-CRP、TNF-α、IL-6水平A组高于B组和C组患者(P<0.05),同时B组患者上述炎症因子水平均高于C组(P<0.05)。大肠杆菌及粪肠球菌水平C组明显低于A组和B组(P<0.05),嗜酸乳酸杆菌、双歧杆菌水平C组明显高于A组和B组(P<0.05)。相关性分析显示:尿毒症患者的炎性因子TNF-α、hs-CRP、IL-6水平与患者体内的大肠杆菌、粪肠球菌的数量呈正相关(P<0.05),与患者体内的嗜酸乳酸杆菌、双歧杆菌数量呈负相关(P<0.05)。结论炎症状态和肠道菌群紊乱是尿毒症行维持性血液透析患者体内普遍存在的现象,各种不同的血液净化方式均可改善患者的炎症状态及肠道菌群紊乱,实验结果表明,对尿毒症患者实施联合血液灌流的组合式血液净化方式较普通的血液透析治疗对于改善患者体内的炎症状态和肠道菌群紊乱更有效。Objective To deeply analyze the specific effects of different blood purification methods on the inflammatory factors and levels of intestinal flora structure in patients with uremia,and explore the potential connections between them.Methods 90 patients with uremia who received MHD at the Blood Purification Center of The People's Hospital of Dingxi from January 2022 to January 2024 were selected as the study subjects.According to different blood purification methods,the patients were divided into three groups:Group A(hemodialysis,n=28),Group B(hemodialysis+hemodiafiltration,n=30),and Group C(hemodialysis+hemodiafiltration+hemoperfusion,n=32).The contents of escherichia coli,enterococcus faecalis,lactobacillus acidophilus,and bifidobacterium in the feces of the three groups of uremia patients were determined by PCR method;ELISA was used to measure the levels of TNF-α,hs-CRP,and IL-6 in three groups of uremia patients;explore the correlation between intestinal flora and micro inflammatory factors through pearson correlation analysis.Results After dialysis,the levels of hs-CRP,TNF-α,and IL-6 in Group A were higher than those in Group B and Group C patients(P<0.05).At the same time,the levels of the above-mentioned inflammatory factors in group B were higher than those in group C(P<0.05).The levels of escherichia coli and enterococcus faecalis in Group C were significantly lower than those in Group A and Group B(P<0.05),while the levels of lactobacillus acidophilus and bifidobacterium in Group C were significantly higher than those in Group A and Group B(P<0.05).Correlation analysis showed that the levels of inflammatory factors TNF-α,hs-CRP,and IL-6 in patients with uremia were positively correlated with the number of escherichia coli and enterococcus faecalis in the patients'body(P<0.05),and negatively correlated with the number of lactobacillus acidophilus and bifidobacterium in the patients'body(P<0.05).Conclusion Inflammatory state and intestinal flora disorder are common phenomena in maintenance hemodialysis

关 键 词：尿毒症 肠道菌群 炎症因子 

分 类 号：R459.5[医药卫生—治疗学]