论文部分内容阅读
目的观察低通量血液透析(LFHD)、高通量血液透析(HFHD)和血液透析+血液灌流(HD+HP)对糖尿病肾病患者同型半胱氨酸及微炎症状态的影响。方法选取维持血液透析(MHD)患者60例随机分为LFHD组、HFHD组、HD+HP组各20例,检测治疗前后Hcy、hs-CRP、IL-6、TNF-α。另纳入30例健康体检者作为对照组,进行分析比较。结果与健康对照组比较,3组糖尿病肾病MHD患者透析前Hcy、hs-CRP、IL-6、TNF-α均高于对照组(P<0.01)。LFHD组治疗6个月后Hcy、hs-CRP、IL-6、TNF-α水平均降低不显著(P>0.05);HFHD组和HD+HP组治疗6个月后Hcy、hs-CRP、IL-6、TNF-α水平均有下降(P<0.05),且HD+HP组低于HFHD组(P<0.05)。结论糖尿病肾病MHD患者存在微炎症状态,HFHD和HD+HP可降低Hcy水平,改善微炎症状态。
Objective To observe the effects of low-flux hemodialysis (LFHD), high-flux hemodialysis (HFHD) and hemodialysis + hemoperfusion (HD + HP) on the plasma homocysteine and microinflammatory state in patients with diabetic nephropathy. Methods Sixty patients with maintenance hemodialysis (MHD) were randomly divided into two groups: LFHD group, HFHD group and HD + HP group. Hcy, hs-CRP, IL-6 and TNF-α were measured before and after treatment. Another 30 healthy subjects were included as a control group for analysis and comparison. Results Compared with the healthy control group, the levels of Hcy, hs-CRP, IL-6 and TNF-α in the MHD patients with diabetic nephropathy were significantly higher than those in the control group (P <0.01). The levels of Hcy, hs-CRP, IL-6 and TNF-α in LFHD group were not significantly reduced after 6 months of treatment (P> 0.05). The levels of Hcy, hs-CRP, IL -6 and TNF-α (P <0.05), and lower in HD + HP group than in HFHD group (P <0.05). Conclusions Microinflammatory state exists in MHD patients with diabetic nephropathy. HFHD and HD + HP can reduce the level of Hcy and improve the microinflammatory state.