血液透析与腹膜透析对终末期肾病患者血脂、氧化应激及炎症因子的影响

EFFECTS OF HEMODIALYSIS AND PERITONEAL DIALYSIS ON SERUM LIPID,OXIDATIVE STRESS AND INFLAMMATORY FACTORS IN PATIENTS WITH END STAGE RENAL DISEASE

目的探讨血液透析与腹膜透析对终末期肾病(ESRD)患者血脂、氧化应激及炎症因子的影响。方法回顾性分析我院2016年1月—2018年12月收治的130例ESRD患者的临床病历资料,根据透析方式的不同分为血透组(69例)和腹透组(61例),比较二组治疗前后肾功能、血脂、氧化应激以及炎症因子水平变化,记录二组治疗期间并发症发生情况。结果二组治疗后肾功能指标Kt/V、Scr、BUN水平比较,差异无统计学意义(P>0.05);腹透组治疗后低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、总胆固醇(TC)、白细胞介素-8(IL-8)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、丙二醛(MDA)水平明显低于血透组(P<0.05),高密度脂蛋白胆固醇(HDL-C)、总抗氧化能力(T-AOC)、超氧化物歧化酶(SOD)、血清谷胱甘肽过氧化物酶(GSH-Px)水平明显高于血透组(P<0.05);腹透组并发症发生率为6.56%明显低于血透组18.84%(P<0.05)。结论腹膜透析治疗效果良好,可纠正终末期肾病患者血脂代谢紊乱,减轻机体氧化应激损伤、改善其炎症因子失衡状态。

Objective To explore effects of hemodialysis(HD)and peritoneal dialysis(PD)on serum lipid,oxidative stress and inflammatory factors in patients with end stage renal disease(ESRD).Methods Clinical case data of one hundred and thirty ESRD patients who were admitted to Baotou Central Hospital from January 2016 to December 2018 were retrospectively analyzed.According to different dialysis methods,they were divided into HD group(n=69)and PD group(n=61).The changes in renal function,serum lipid,oxidative stress and levels of inflammatory factors before and after treatment were compared between the two groups.The occurrence of complications during treatment in both groups was recorded.Results After treatment,there were no significant differences in levels of renal function indexes such as Kt/V,Scr and BUN between the two groups(P>0.05).After treatment,levels of low-density lipoprotein cholesterol(LDL-C),triglyceride(TG),total cholesterol(TC),interleukin-8(IL-8),interleukin-6(IL-6),hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)and malondialdehyde(MDA)in PD group were significantly lower than those in HD group(P<0.05),while levels of levels of high-density lipoprotein cholesterol(HDL-C),total antioxidant capacity(T-AOC),superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)were significantly higher than those in HD group(P<0.05).The incidence of complications in PD group was significantly lower than that in HD group(6.56%vs.18.84%)(P<0.05).Conclusion The curative effect of PD is good,which can correct lipid metabolism disorders in ESRD patients,alleviate oxidative stress injury,and inflammatory factors imbalance status.