高通量透析对维持性血液透析患者微炎症状态和营养状态的影响

Effect and Mechanism of High-Flux Hemodialysis on Microinflammatory Status and Nutrition Status in Maintenance Hemodialysis Patients

目的探讨高通量透析对维持性血液透析患者微炎症状态和营养状态的作用及其机制。方法将维持性血液透析患者40例随机均分为高通量透析组与常规血液透析组,以10名健康志愿者作为正常对照组,分别测定各组治疗前和维持性血液透析治疗12周后的血浆总蛋白水平、血浆白蛋白水平、体重指数、血浆细胞因子(白细胞介素6、肿瘤坏死因子α、超敏C反应蛋白)变化。结果维持性血液透析患者治疗前的血浆细胞因子水平均显著高于正常对照组(P<0.05);高通量透析组治疗12周后各血浆细胞因子水平较治疗前明显降低,微炎症状态明显改善(P<0.05),营养状况指标明显改善(P<0.05);常规血液透析组治疗12周后各血浆细胞因子水平较治疗前无明显变化,营养状况指标改善也不明显。结论维持性血液透析患者普遍存在微炎症状态;与常规血液透析相比,高通量透析能有效清除微炎症细胞因子,改善患者营养状况。

Objective To investigate the effect and the mechanism of different dialysis modes：high-flux hemodialysis and hemodialysis on microinflammatory status and nutrition status.Methods Forty patients were divided into two groups at random：the group of high-flux hemodialysis（MHD,n=20） and the group of hemodialysis（CHD,n=20）.TP,ALB,BMI,IL-6,TNF-α,hs-CRP were examined before and after dialysis after treatment about 12 weeks.Results Compared with the normal control group,cytokine in the CHD group were much higher（P0.05）.Compared with the CHD group,cytokine in the HPD group decreased markedly（P0.05）,microinflammatory status and nutrition status were greatly improved（P0.05）.Conclusion Microinflammatory status exists commonly in the maintenance hemodialysis patients.The microinflammation with uremia can be eliminated effectively by high flux hemodialysis membrane therapy and the nutrition status in patients will be enhanced.