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目的探讨重组人红细胞生成素-β注射液对糖尿病肾病(DN)腹膜透析患者炎症因子水平及氧化应激水平的影响。方法选取2014年2月至2016年2月于淮安市肿瘤医院肾内科接受治疗的DN并行腹膜透析患者48例,随机分为对照组和观察组,每组24例。对照组接受常规腹膜透析治疗,观察组在常规腹膜透析基础上,予重组人红细胞生成素-β注射液(一周2次,每次10 000 IU)。比较两组治疗前后的血红蛋白(Hb)、红细胞压积(Hct)及Fe~(2+)水平等贫血指标,尿白蛋白排泄率(UAER)、血肌酐(SCr)水平等肾功能指标,白介素6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)等炎症因子水平以及丙二醛(MAD)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平等氧化应激指标的变化。结果治疗后,两组Hb、Hct及Fe~(2+)水平较治疗前均有显著升高(P<0.01或P<0.05);UAER及SCr水平较治疗前均显著下降(P<0.01);IL-6、CRP及TNF-α水平较治疗前均显著下降(P<0.01或P<0.05);MDA水平较治疗前显著降低,SOD及GSH-Px水平较治疗前显著上升(P<0.01),且观察组上述指标变化均更显著(P<0.01或P<0.05)。结论重组人红细胞生成素-β注射液用于行腹膜透析DN患者的辅助治疗,有助于改善患者的贫血症状及肾功能,降低血清炎症因子水平,缓解机体的氧化应激状态。
Objective To investigate the effect of recombinant human erythropoietin-β injection on inflammatory cytokines and oxidative stress in patients with diabetic nephropathy (DN) peritoneal dialysis. Methods Forty-eight patients with DN complicated with peritoneal dialysis undergoing nephrology of Huai’an Tumor Hospital from February 2014 to February 2016 were randomly divided into control group and observation group, with 24 cases in each group. The control group received routine peritoneal dialysis, and the observation group received recombinant human erythropoietin-β injection (twice a week, 10 000 IU each time) on the basis of routine peritoneal dialysis. The levels of hemoglobin (Hb), hematocrit (Hct) and Fe2 +, anemia index, urinary albumin excretion rate (UAER) and serum creatinine (SCr) were compared between the two groups before and after treatment. IL-6, CRP, TNF-α and other inflammatory factors, as well as the levels of malondialdehyde (MAD), superoxide dismutase (SOD), glutathione peroxidation (GSH-Px) levels and other indicators of changes in oxidative stress. Results After treatment, the levels of Hb, Hct and Fe 2+ in both groups were significantly higher than those before treatment (P <0.01 or P <0.05), while the levels of UAER and SCr were significantly lower than those before treatment (P <0.01) ; The levels of IL-6, CRP and TNF-α were significantly lower than those before treatment (P <0.01 or P <0.05); the levels of MDA were significantly lower than those before treatment; the levels of SOD and GSH-Px were significantly increased ), And the above indicators in the observation group changed more significantly (P <0.01 or P <0.05). Conclusions Recombinant human erythropoietin-β injection is an adjunctive therapy for peritoneal dialysis patients with DN, which can help to improve anemia and renal function, reduce serum levels of inflammatory cytokines and alleviate oxidative stress.