高通量透析对维持性血液透析治疗患者可溶性细胞间黏附因子及炎症因子的影响

Effect of high-flux hemodialysis on the soluble intercellular adhesion molecule-1 and inflammatory factors in maintenance hemodialysis patients

目的:探讨高通量透析对维持性血液透析治疗(MHD)患者可溶性细胞间黏附因子(sICAM-1)及炎症因子的影响。方法:选取40例MHD患者,分为常规透析组(HD组)和高通量透析组(HFHD组),观察12周,分别在实验开始及实验结束透前、透后测定C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、β2微球蛋白(β2MG)、sICAM-1浓度,并计算实验开始及实验结束时的尿素清除指数(KT/V)。结果:HFHD组中,CRP、TNF-α、β2MG、sICAM-1浓度在实验结束时均有下降,透后与透前比较差异有统计学意义(P<0.05),TNF-α、β2MG、sICAM-1浓度实验结束透前与实验开始比较差异有统计学意义(P<0.05),实验结束时β2MG、sICAM-1浓度与HD组比较差异有统计学意义(P<0.05)。HD组中,CRP、TNF-α、β2MG、sICAM-1浓度在实验结束时均有升高。结论:与常规透析相比,使用高通量透析器维持血液透析,患者sICAM-1及TNF-α浓度可降低。

Objective： To study the effect of high-flux hemodialysis on the soluble intercellular adhesion molecule-1 and inflammatory factors in maintenance hemohemodialysis patients. Methods： Forty MHD patients were selected and divided into two groups, conventional hemodialysis group （HD group） and high flux hemodialy- sis group （HFHD group）, the observation time was twelve weeks. The concentrations of slCAM-1, TNF-α, CRP, β2MG were measured at the beginning, pre-dialysis and post-dialysis of the end of experiment. The value of KT/ V at the beginning and the end of experiment was calculated. Results： In HFHD group, the concentrations of CRP, TNF-α, β2MG, slCAM-1 decreased at the end of experiment, it had significant difference at post-hemodialysis compared to pre-hemodialysis （P〈0.05）. The concentrations of TNF--α, β2MG, slCAM-1 at pre-hemodialysis of the end of experiment had statistically difference compared to the beginning of the experiment （P〈0.05）, and at the end of experiment, the concentrations of β2MG, slCAM-1 had significant difference compared to the HD group （P〈0.05）. In HD group, the concentrations of CRP, TNF-α, β2MG, slCAM-1 all increased at the end of experiment. Conclusion： Compared to the conventional hemodialysis, high-flux hemodialysis can decrease the concentration of slCAM- 1 and TNF-α.