血液透析滤过对糖尿病肾衰竭患者微炎性反应的改善作用观察

Improved effect observation of hemodiafiltration on micro-inflammatory reaction of patients with diabetic nephropathy

目的 探讨血液透析滤过对糖尿病肾衰竭患者微炎性反应的影响。方法 选择本院2010年1月~2013年12月收治入院的2型糖尿病肾病患者100例采用血液透析滤过治疗作为观察组,另选择本院同期收治的采用常规血液透析治疗的非糖尿病患者100例作为对照组,观察两组治疗前后24 h尿蛋白定量、血肌酐（SCr）、血清尿素氮（BUN）、C反应蛋白（CRP）、白细胞介素-1（IL-1）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平。结果观察组治疗后的CRP、IL-1、IL-6、TNF-α水平低于治疗前（P〈0.05）;对照组治疗后的IL-1水平低于治疗前（P〈0.05）;治疗后,观察组CRP、IL-6、TNF-α水平明显低于对照组（P〈0.05）。观察组治疗后的24 h尿蛋白定量、BUN、SCr水平低于治疗前（P〈0.05）;对照组治疗后的24 h尿蛋白定量、SCr水平低于治疗前（P〈0.05）;治疗后,观察组的24 h尿蛋白定量、SCr水平明显低于对照组（P〈0.05）。结论 血液透析滤过可改善糖尿病肾病患者的微炎症状态和免疫功能,消除或控制促炎因素,并延缓慢性肾脏病的发生、发展。

Objective To explore the effects of hemodiafiltration on micro-inflammatory reaction of patients with diabetic nephropathy. Methods 100 patients with type 2 diabetic nephropathy admitted to our hospital from January 2010 to December 2013 were selected as observation group receiving hemodiafihration treatment.Another 100 patients without diabetes admitted to our hospital during the same period were selected as control group receiving hematodialysis treatment.Level of 24-h urine protein,SCr, BUN,CRP,IL-1,IL-6 and TNF-α before and after the treatment were observed in two groups respectively. Results Level of CRP,IL-1,IL-6 and TNF-α after treatment in observation group was lower than that before treatment respectively（P〈0.05）.Level of IL-1 after treatment in control group was lower than that before treatment（P〈0.05）.After treatment,level of CRP,IL-6 and TNF-α in observation group was lower than that in control group respectively （P〈0.05）.Level of 24-h urine protein,BUN and SCr after treatment in observation group lower than that before treatment respectively （P〈0.05）.Level of 24-h urine protein,BUN after treatment in control group lower than that before treatment respectively（P〈0.05）.After treatment,level of 24-h urine protein and SCr in observation group was lower than that in control group respectively （P〈0.05）. Conclusion Hemodiafiltration can improve micro-inflamma tory state and immune function in patients with diabetic nephropathy,eliminate or control the proinflammatory factor,and delay the occurrence and development of chronic kidney disease.