血液透析滤过对尿毒症炎症因子的影响

The oberseration on the change of inflammatory factors in urinemia patients by on-line hemodiafiltration

目的初步探讨联机血液透析滤过对危重尿毒症炎症因子的影响及其临床意义。方法前瞻性选取我院2006年1月-2007年12月收治的23例危重尿毒症患者，分为对照组和实验组：对照组给予血液透析治疗，实验组给予联机血液透析滤过治疗。治疗前及治疗后2周分别测定两组患者血清肿瘤坏死因子（TNF-α）、C反应蛋白（CRP）、白介素-10（IL-10）滴度及IL-10／TNF-α的比值；评估患者的病情转归。结果与对照组相比，实验组治疗2周后血清TNF-α、CRP滴度下降显著，IL-10／TNF-α比值增高，且治疗耐受性好，病情缓解率高（89％）。结论联机血液透析滤过可清除部分炎症因子，在阻断瀑式炎症反应的同时激活体内的抗炎反应，调节机体的免疫状态，从而改善危重尿毒症患者的病情。

Objective To investigate the effect of on-line hemodiafiltration on serum levels of inflammatory factors in urinemia patients. Methods 23 cases of urinemia patients were observed in this prospective control study. All cases were divided into 2 groups： control group（hemodialysis） and treatment group（on-line hemodiafiltration）. The plasma concentration of TNF-α, CRP, IL-10/TN-α were determined before and 2 weeks after treatment respectively; the clinlical outcomes of two groups were evaluated. Results Compared with the control group, the patients in the experiment group were tolerat well to the on-line hemodiafiltration. On-line hemodiafiltration can eliminate inflammatory factors ,lead to the deline of plasma concentration of TNF-α, CRP and the increased ratio of plasma concentration of IL-10/TNF-α. Conclusions The on-line hemodiafihration can treat urinemia patients effectively through eliminate certain inflammatory factors, block the excessive inflammatory reaction.