血液透析串联血液灌流对维持性血液透析患者微炎症及血管内皮功能的影响

Effect of hemodialysis with hemo-perfusion on microinflammatory and vascular endothelial function of chronic hemodialysis patients

目的探讨血液透析串联血液灌流对维持性血液透析患者促炎因子及血管内皮功能的影响。方法我院透析中心血液透析患者25例。10例行单纯血液透析治疗，15例血液透析串联血液灌流治疗，选择10例健康人作为正常对照。观察与单纯血液透析相比，串连灌流治疗前、连续4次强化治疗后促炎因子TNF—a及VCAM一1的改变。结果维持性血液透析患者血中TNF—a、sVCAM-1的水平明显高于正常人。治疗前MHD患者血TNF—a与sVCAM-1水平呈显著正相关关系（r=0．674，P〈0．05）。患者血液透析串联血液灌流连续4次治疗后血中TNF—a、VCAM-1水平均明显下降。而单纯血液透析治疗组，TNF—a、sVCAM-1无明显改变。结论血液透析患者体内炎症状态可能导致了血管内皮功能损伤。血液透析串联血液灌流改善了患者体内微炎症状态并减轻血管内皮功能损伤。

Objective To investigate the effect of hemodialysis with hemo-perfusion on microinflammatory and vascular endothelial function of chronic hemodialysis patients.Methods Twenty hemodialysis patients were divided into two groups, 10 patients received hemodialysis therapy for four times （as control group）, and 15 patients received hemodialysis with hemoperfusion（HD＋HP） therapy for four times. The level of TNF-α and sVCAM-1 were detected before therapy and after therapy for four times. Results The level of TNF-α and sVCAM-1 in chronic hemodialysis patients were higher than that of control group; The level of TNF-α were positive correlated with the level of sVCAM-1 （ r=0.674, P〈 0.05 ） before therapy; The level of TNF-α and sVCAM-1 in hemo-perfusion group patients decreased after therapy for 4 times. There was statistically difference between before and after therapy （P〈0. 05）; while in control group, both of them showed no statistically different （P〉0.05）. Conclusions Microinflammatory possibly lead to vascular endothelial function damage in chronic hemodialysis patients.Hemodialysis with hemoperfusion could effectively reduce mieroinflammation and alleviate vascular endothelial function damage in chronic hemodialysis patients.