摘要
目的:观察血液透析滤过对终末期肾病患者BNP及胰岛素抵抗的影响,探讨血液透析滤过(HDF)对维持性血液透析患者心血管疾病改善的作用机制。方法:将107例终末期肾病患者随机分为常规血液透析组(HD)和血液透析滤过组(HDF),HDF组在常规透析基础上,每2周行血液透析滤过一次,4h/次。观察比较治疗6个月后HD组和HDF组患者BNP、HOMA-IR、hs-CRP、体质量指数(BMI)、胆固醇、高密度脂蛋白、甘油三酯、尿酸等指标的变化,分析干预治疗6个月后BNP与各变量间的相关性。结果:基线水平HD和HDF两组间各项指标比较差异无统计学意义(P>0.05)。干预治疗6个月后HD与HDF组患者体重指数、总胆固醇、高密度脂蛋白、甘油三酯比较差别均无统计学意义(P>0.05)。HDF组BNP、HOMA-IR、尿酸、hs-CRP水平明显低于HD组(P<0.05或P<0.01)。HOMA-IR与BNP有显著相关关系(r=0.49,P<0.01),BNP、HOMA-IR与BMI(r=0.25,P<0.05;r=0.58,P<0.01)、尿酸(r=0.23,P<0.05;r=0.26,P<0.05)、hs-CRP(r=0.44,P<0.01;r=0.31,P<0.01)有显著正相关关系。HOMA-IR、尿酸、hs-CRP是终末期肾病血透患者BNP水平主要影响因素。结论:在终末期肾病血液透析患者HOMA-IR与BNP有显著相关性,HDF在改善透析患者胰岛素抵抗及微炎症状态及降低BNP水平方面,比普通血液透析具有更大的优势。
Objective: To observe the influence of hemodiaf/ltrat/on ( HDF )on B-type brain uatriuretic peptide and insulin resistanc in maintence hemodialysis patients and to investigate the mechanism of role which HDF relieve cardiovascular disease in patients with MHD.Method: 107 cases patients with MHD were randomly divided into two groups, HD ( treated with HD ) and HDF ( treated with HDF every two weekly in addition to I-ID ) .The patients serum BNP, HOMA-IR, hs-CRP, BMI, cholesterin, HDL, triglyceride, uric acid were detected after 6 months.Analysing the correlation of BNP and the other variables after 6 months for : Indicators of HD and HDF groups in Baseline levels have no statistical significance ( P〉0.05 ) .After 6 months observation, the levels of BMI, total cholesterol, HDL, triglyceride in two groups have no statistical significance ( P〉0.05 ), the levels of BNP, HOMA-IR, hs-CRP and uric acid were significantly decreased according to HD groups ( P〈0.05 or P〈0.01 ) .HOMA IR and BNP have significant correlation (r=0.49, P〈0.01 ) .The BNP and HOMA IR were significantly positive correlation to BMI (r=0.25, P〈0.05; r=0.58, P〈0.01 ), uric acid ( r=0.23, P〈O.05 ; r=-0.26, P〈0.05 ) and hs-CRP ( r=0.44, P〈0.01 ; r=0.31, P〈0.01 ) .HOMA IR, uric acid and the hs-CRP are the main influencing factors of BNP levels in patients with end-stage renal diseases.Conclusioni HOMA-IR has significant correlation with the BNP in hemodialysis patients with end-stage renal disease.HDF could better reduce insulin resistance and microinflammation state than HD therapy, which may also reduce the level of BNP.
出处
《中国医学创新》
CAS
2013年第23期17-19,共3页
Medical Innovation of China
关键词
血液透析滤过
终末期肾病
B型脑钠肽
胰岛素抵抗
Hemodiafihration
End stage renal disease
B-type brain natriuretic peptide
Insulin resistance