高通量透析改善老年血液透析患者微炎症状态的临床研究

Clinical Research on the Alleviative Roles of Microinflammatory State in Elderly Hemodialysis Patients Using High-flux Membrane Dialyzer

目的:探讨高通量透析对老年维持性血液透析患者微炎症状态的影响。方法:将常规血液透析老年患者80例,随机分为高通量组及常规透析组。检测各组患者治疗前后的血清超敏C反应蛋白、白细胞介素6、肿瘤坏死因子α、同型半胱氨酸、丙二醛、白蛋白、转铁蛋白、血红蛋白、全段甲状旁腺素等,治疗观察时间为3个月。结果:高通量透析组(A组)和常规透析组(B组)患者治疗前后血清学CRP、IL-6、TNF-α、Hcy、MDA、iPTH水平比较,A组治疗3月后各项指标较治疗前明显下降(P<0.05),而B组治疗后各项指标下降不明显,治疗3月时A、B两组间各项指标差异有统计学意义(P<0.05);MHD组患者CRP与IL-6、TNF-α、Hcy、MDA、iPTH呈显著正相关(分别为r=0.526,P<0.01;r=0.511,P<0.01;r=0.269,P<0.05;r=0.302,P<0.05;r=0.712,P<0.01)。结论:高通量血液透析可以改善血透患者微炎症状态。

Objective：Objective Study the effects of high-flux membrane dialysis on microinflammatory state in elderly hemodialysis patients. Methods：80 elderly maintenance hemodialysis patients were divided into high-flux hemodialysis group （Group A）and conventional hemodialysis group （Group B）. Serum high sensitive protein,interleukin6,tumor necrosis factor, alpha, homocysteine, malondialdehyde, albumin, transferring levels, hemoglobin, intact parathyroid hormone levels were detected before and after 3 months of hemodialysis in Group A and Group B. Results：CRP,IL-6,TNF alpha, Hcy, MDA, iPTH in serum of Group A were decreased significantly after high-flux hemodialysis （P〈0.05）. In conventional hemodialysis group, there was no significant difference before and after convention hemodialysis（P〈0.05）. The comparison of Group A and Group B showed difference（P〈0.05）after 3 months of the treatment. CRP level in serum of high-flux hemodialysis group was positively associate with IL-6,TNF alpha, Hcy, MDA, iPTH （r=0.526,P〈0.01;r=0.511,P〈0.01;r=0.269,P〈0.05;r=0.302,P〈0.05;r=0.712, P〈0.01） Conclusion：High-flux hemodialysis could reduce the microinflammatory state in elderly maintenance hemodialysis patients.