高通量透析器治疗尿毒症患者高瘦素血症及清除炎症介质效果研究

The effect of high flux dialyzer on hyperleptinemia and inflammatory mediator in uremic patients

目的:观察HPD及HDF治疗尿毒症患者高瘦素血症及清除炎症介质效果,旨在改善CRF患者的生活质量。方法:60例患者随机分为,高通量血透(A)组、血液透析滤过(B)组各30例,正常健康体检者30例做对照(C)组。观察尿毒症患者治疗前后、3月血清瘦素、TNF、IL-6、IL-8水平及观察体重指数(BMI)、血压、食欲、精神状态、贫血改善情况,与正常对照组、组间及自身治疗前后对照。结果:血清瘦素、TNF、IL-6、IL-8浓度透前AB组与C组比较显著增高;透后AB组与自身透前比较显著降低;透后3个月AB组与自身透前比较显著降低;透后3个月B组比A组显著降低。AB组BMI、血压、食欲、精神状态均有不同程度改善。结论:HPD及HDF对清除尿毒症患者血清瘦素及炎症介质有明显的作用,可较好的改善患者的慢性炎症和营养不良状态,提高生活质量,HDF比HPD可能更明显一些,值得进一步研究。

Objective： To observe the effect of high flux dialyzer on hyperleptinemia and inflammatory mediator in uremic patients. Methods：Sixty patients with uremia were randomly divided into two groups equally, A group treated with HPD, and B group treated with HDF. We observed sixty patients＇ serum leptin,TNF,IL-6, IL-8,body mass index （BMI）, blood pressure, appetite, mental sta＇tus and the improvement of anemia before and three months after treatment, and thirty healthy individuals, aseontrol （C group）. Results： The serum levels of leptin,TNF,IL-6 and IL-8 in A and B groups were significantly increased as compared with those in C group before the treatment, while they were decreased significantly in A and B groups after the treatment and three months after the treatment ;as compared with those before the treatment, and they were also decreased significantly in B group as compared with those in A group three months after the treatment. The BMI, blood pressure, appetite and mental status in A and B group were improved. Conclusion ： The treatment with HPD and HDF can scavenge serum leptin and inflammatory mediators in uremic patients, which can improve the patient＇s status of chronic inflammation and malnutrition and improve their quality of life. The treatment outcomes of HDF are better than those of HPD, which is worth further studying.