高通量透析膜对C-反应蛋白及血脂代谢的影响

Influence of high flux hemodialysis on C-reactive protein and lipids metabolism

背景:传统低通量透析不能改善微炎症状态和脂质代谢紊乱,新型的高通量透析则可以很好的改善这种微炎症状态和脂质代谢,有助于提高患者的生活质量和存活率,因此如何改善微炎症状态和脂质代谢成为人们研究的热点。目的:观察高通量和低通量聚砜膜血液透析器对维持性血液透析患者血浆超敏C-反应蛋白及血脂代谢的影响。方法:将44例维持性血液透析患者随机分为高通量透析组和低通量透析组,另选22例健康体健者作为正常对照组。高通量透析组使用高通量透析器FX60,低通量透析组使用低通量透析器F6,均每周透析3次,每次透析4h;治疗1年后,分别比较两组患者治疗前后及与正常对照组的血超敏C-反应蛋白与总胆固醇、三酰甘油及低密度脂蛋白胆固醇等指标的变化。结果与结论:两组治疗前血浆超敏C-反应蛋白与三酰甘油、总胆固醇及低密度脂蛋白胆固醇水平均高于正常对照组(P<0.05);治疗后高通量透析组患者的血浆超敏C-反应蛋白与总胆固醇、三酰甘油及低密度脂蛋白胆固醇水平明显下降(P<0.05),而低通量透析组无明显变化(P>0.05)。结果提示采用高通量FX60聚砜膜透析器进行透析能改善维持性透析患者的微炎症状态及脂质代谢。

BACKGROUND：Traditional low-flux dialysis cannot improve micro-inflammatory status and lipid metabolism disorders,while new high-flux dialysis can improve the micro-inflammation and lipid metabolism,it helps to improve the quality of life and survival rate of patients,so how to improve the micro-inflammatory status and lipid metabolism are a focus for researchers.OBJECTIVE：To observe the effect of high flux hemodialysis（HFHD） with FX60 polysulfone dialyser and low flux hemodialysis（LFPD） with F6 polysulfone dialyser on high-sensitivity C-reactive protein and lipid metabolism in patients with maintenance hemodialysis.METHODS：Forty-four patients with maintenance hemodialysis were randomly divided into HFHD group and LFHD group.Another 22 cases for physical examinations served as normal control group.The maintenance hemodialysis patients were treated with HFHD using FX60 dliahyser or LFPD using F6 dialyser,three times per week,4 hours once.After 1 year of the treatment,high-sensitive C-reactive protein and total cholesterol,triacylglycerol and low density lipoprotein cholesterol were determined in patients as well as normal controls before and after treatment.RESULTS AND CONCLUSION：In two groups,the levels of high-sensitive C-reactive protein and total cholesterol,triacylglycerol and low density lipoprotein cholesterol before the treatment were higher than normal control（P 0.05）.In HFPD group,serum high-sensitive C-reactive protein and total cholesterol,triacylglycerol and low density lipoprotein cholesterol markedly decreased（P 0.05）.In LFHD group,these indices remained unchanged after the dialysis for one year.HFPD with FX60 polysulfone dialyser is effective in improving lipid metabolism and micro-inflammation in maintained hemodialysis patients.