维持性血液透析患者血浆内毒素水平对透析中不良反应的影响

Impacts of plasma endotoxin levels on maintenance hemodialysis-induced adverse effects

目的：研究维持性血液透析患者血浆内毒素水平与透析中不良反应的相关性。方法：选择本院2008年4月-2009年10月30例维持性血液透析治疗患者，采集血标本测量血浆内毒素值，根据内毒素值水平分为高浓度组和低浓度组，比较两组间不良反应的发生率。结果：内毒素高浓度组和低浓度组的透析不良反应的发生率分别为：（1）低血压：25．3％和18．6％（P〈0．05）；（2）恶心、呕吐：17．8％和13．3％（P〈0．05）；（3）发热：15．2％和8．1％（P〈0．05）；（4）肌肉痉挛：16．3％和12．5％（P〈0．05）；结论：维持性血液透析患者血浆内毒素水平会影响透析中不良反应如低血压、发热、恶心呕吐、肌肉痉挛的发生率，他们之间存在相关性。

Objective：To investigate the correlation between plasma endotoxin levels in maintenance hemodialysis and dialysis-related adverse complications. Methods： Thirty patients on maintenance hemodialysis during April ,2008 to October,2009 in our hospital were recruited. Blood samples were collected to measure plasma endotoxin levels. According to plasma endotoxin levels, the patients are divided into the high-level and low-level groups. Incidence of adverse effects was compared between these two groups using the Chi square test. Results： The incidence rate of dialysis-related adverse complications in the high-level group vs low-level group was： 25.3% vs 18.6% for hypotension （P〈0.05）,17.8% vs 13.3% for nausea and vomiting （P〈0.05）,15.2% vs 8. 1% for fever （P〈0.05）,and 16. 3% vs 12.5 % for muscle cramps （P 〈 0. 05 ）. Conclusion：Plasma endotoxin level was shown to correlate with and affect the incidence rate of adverse dialysis-related complications such as low blood pressure, fever, nausea and vomiting, muscle cramps.