两种血液吸附器血透对尿毒症患者血清β_2-MG和IL-6的影响

The impact of two blood absorber hemodialysis on the level of β_2-MG and IL-6 in uremia patients.

目的探讨中性树脂HA-330型和活性炭YTS-200型血液吸附器串连低通量血液透析对尿毒症患者血清β2-MG和IL-6的影响。方法30例维持性血透病人,交叉对照设计,清洗期1周;以常规间隙性低通量透析(IHD)为基础治疗,HA-330和YTS-200两种不同的血液吸附器为干预手段与F6低通量血液透析器串连,检测治疗前后血常规、肝肾功能、电解质、血清β2微球蛋白(β2-MG)、白介素6(IL-6)水平,计算治疗后β2-MG、IL-6的下降率,比较三种治疗对血清β2-MG、IL-6、血小板的影响。结果正常对照血清IL-6为106·467±89·585pg/ml,β2-MG为81·579±25·417nmol/L;30例尿毒症病人,去除血液浓缩影响,IHD、IHD+HA-330、IHD+YTS-200三种治疗IL-6/HCT的下降率分别为8·1±40·2、-15·1±110·7、-10·8±96·8,三者间差异无显著性(P>0·05);IHD、IHD+HA-330、IHD+YTS-200三种治疗β2-MG/HCT的下降率分别为-9·5±60·8、-16·4±43·1、-6·6±26·7,三者间差异无显著性(P>0·05);IHD治疗前后PLT/HCT为77·75±31·60、80·59±34·55,差异无显著性(P>0·05);IHD+HA-330治疗前后PLT/HCT分别为82·21±39·22、68·94±33·55,治疗后显著降低(P<0·05),IHD+YTS-200治疗前后PLT/HCT为70·64±27·46、53·56±20·80,治疗后显著降低(P<0·05)。结论IHD、IHD+HA-330、IHD+YTS-200三种治疗后尿毒症患者血清β2-MG、IL-6无降低;HA-330、Aier-200引起PLT显著降低,提示HA-330和YTS-200两种血液吸附器生物相容性欠佳。

Objective To study the influence of synthetic polymers type HA - 330 and actived carbon type YTS - 200 hemoadsorption devices conjugated with low flux bemodialysis on uremic patients＇ serum β2- MG and IL- 6. Methods Crossover design was made and 30 cases maintenance hemodialysis uremia patients were treated with conventional intermittent low - flux hemodialysis （IHD）, one week as wash - out period, HA - 330 and YTS - 200 hemoadsortion devices conjugated with low flux F6 dialyzer as interferences, blood routine, liver and kidney function index, eletrieytes, serum β2- MG and IL - 6 were measured before and after treatment. The β2- MG and IL- 6 reduction rate of the three kinds therapies and their influences on blood platelet were compared. Results Normal values of IL- 6 andβ2- MG were 106.467±89.585pg/ml and 81.579±25.417nmol/L. The reduction rate of serum IL - 6/HCT in the 30 cases uremia patients after treated with IHD,IHD ＋ HA - 330,IHD ＋ YTS - 200 were 8.1±40.2 , - 15.1±110.7 and - 10.8±96.8,respectively. No significant difference was observed （P 〉 0.05）; the reduction rate of IHD,IHD ＋ HA - 330,IHD ＋ YTS - 200 to serum β2- MG/HCT was - 9.5±60.8, - 16.4±43.1, - 6.6±26.7 respectively, no significant difference （ P 〉 0.05） ; the levels of PLT and HCT were 77.75±31.60 and 80.59±34.55 before and after IHD therapy, no significant difference was noticed （ P 〉 0.05） ; the levels of blood PLT and HCT before and after IHD ＋ HA - 330 therapy were 82. 21±39.22 and 68.94±33.55 respectively, significantly decreased （ P 〈 0.05）. the levels of blood PLT and HCT before and after IHD ＋ YTS - 200 were 70.64±27.46 and 53.56 ±20.80, significantly decreased （ P 〈 0.05 ）. Conclusion After IHD, IHD ＋ HA - 330, IHD ＋ YTS - 200 therapies, the levels of serum β2- MG and IL - 6 did not decrease. The level of blood PLT decreased significantly after use of HA - 330 and Aier- 200, showing a poor biocompatibility in the use of HA - 330 amd YTS - 200 with.