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目的观察高通量透析对维持性血液透析(MHD)患者中分子毒素水平、炎症状态、血脂代谢的影响。方法将42例MHD患者随机分成高通量透析组和低通量透析组,每组21例,高通量透析组采用GAMBRO Polyflux 17R透析器,低通量透析组采用NIPRO Sureflux-150G透析器,两组患者分别于治疗前及治疗后6个月留取血液标本检查β2-微球蛋白(β2-MG)、超敏C反应蛋白(hs-CRP)和血浆胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)。结果高通量组治疗后β2-MG、hs-CRP下降,与治疗前比较差异有统计学意义(P<0.05),与低通量组比较差异有统计学意义(P<0.05)。高通量组治疗后TC、TG、LDL-C下降,HDL-C升高,与治疗前比较差异有统计学意义(P<0.05),与低通量组比较差异有统计学意义(P<0.05)。结论高通量透析可以有效清除透析患者血液中的中分子毒素水平,减轻慢性微炎症状态,改善透析患者的血脂代谢,有利于改善长期预后,提高患者的生存质量及存活率。
Objective To observe the effects of high-flux dialysis on molecular levels of toxins, inflammatory state and lipid metabolism in maintenance hemodialysis (MHD) patients. Methods 42 cases of MHD were randomly divided into high-throughput dialysis group and low-throughput dialysis group, 21 cases in each group, high-throughput dialysis group GAMBRO Polyflux 17R dialyzer, low-throughput dialysis group NIPRO Sureflux-150G dialyzer, Blood samples were collected before treatment and at 6 months after treatment for the detection of β2-microglobulin (β2-MG), hs-CRP, TC, triglyceride TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C). Results The β2-MG and hs-CRP decreased in the high-dose group after treatment compared with those before treatment (P <0.05). The difference was statistically significant (P <0.05) compared with the low-dose group. The levels of TC, TG, LDL-C and HDL-C in high-dose group were significantly higher than those before treatment (P <0.05), and the difference was statistically significant compared with low-dose group (P < 0.05). Conclusion High-throughput dialysis can effectively remove the levels of intermediate toxins from the blood of dialysis patients, relieve chronic micro-inflammation, improve blood lipid metabolism in dialysis patients, improve long-term prognosis and improve patients’ quality of life and survival rate.