血液透析联合血液灌流对慢性肾衰竭患者微炎症状态与肾功能的影响

Effect of Hemodialysis Combined with Hemoperfusion on Microinflammation and Renal Function in Patients with Chronic Renal Failure

目的探讨慢性肾衰竭(CRF)患者采用血液透析(HD)联合血液灌流(HP)治疗的临床效果.方法选取2020年1月—2021年12月我院收治的80例CRF患者作为研究对象,采用随机数字表法分为两组,各40例.对照组采用HD治疗,观察组在对照组基础上加用HP治疗,均治疗3个月.比较两组治疗前后炎症指标、肾功能指标及血液净化指标,统计两组不良反应发生情况.结果治疗后,两组血清肿瘤坏死因子α(TNF-α)及白细胞介素6(IL-6)水平均比治疗前降低,且观察组TNF-α及IL-6水平均比对照组低,组间差异有统计学意义(P<0.05).治疗后,两组血肌酐(Scr)及血尿素氮(BUN)水平均比治疗前降低,肌酐清除率(Ccr)均比治疗前升高,且观察组Scr及BUN水平均比对照组低,Ccr比对照组高,组间差异有统计学意义(P<0.05).两组治疗后血清甲状旁腺激素(PTH)及β_(2)-微球蛋白(β_(2)-MG)水平均比治疗前降低,且观察组PTH及β_(2)-MG水平均比对照组低,组间差异有统计学意义(P<0.05).两组不良反应发生率比较,差异无统计学意义(P>0.05).结论CRF患者采用HD联合HP治疗,可有效清除肾脏内有毒物质,改善肾功能及微炎症状态,且安全性好.

Objective To investigate the clinical effects of treatment with hemodialysis(HD)combined with hemoperfusion(HP)in patients with chronic renal failure(CRF).Methods 80 patients with CRF admitted to the hospital from January 2020 to December 2021 were selected as the research objects and divided into two groups by random number table method,with 40 cases in each group.The control group was treated with HD,and the observation group was treated with HP on the basis of the control group.Both groups were treated for 3 months.The inflammatory indexes,renal function indexes and blood purification indexes before and after treatment were compared between the two groups,and the incidence of adverse reactions in the two groups was counted.Results After treatment,the serum tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels in the two groups were decreased compared with those before treatment,the levels of TNF-αand IL-6 in the observation group were lower than those in the control group,and the differences between the groups were statistically significant(P<0.05).After treatment,serum creatinine(Scr)and blood urea nitrogen(BUN)levels in both groups were lower than before treatment,and creatinine clearance(Ccr)was higher than before treatment,the levels of Scr and BUN in the observation group were lower than those in the control group,and the level of Ccr was higher than that in the control group,and the differences between the groups were statistically significant(P<0.05).The levels of serum parathyroid hormone(PTH)andβ_(2)-microglobulin(β_(2)-MG)in the two groups after treatment were lower than those before treatment,the levels of PTH andβ_(2)-MG in the observation group were lower than those in the control group,and the differences between the groups were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion HD combined with HP in the treatment of CRF patients can effectively remove toxic substances in the kidney,improve renal function and microinflammation,and has good safety.