不同血液净化治疗方式对尿毒症患者同型半胱氨酸及C-反应蛋白水平的影响

Effects of different blood purification methods on the serum homocysteine and C-reactive protein levels of patients with uremia

目的观察不同方式的血液净化治疗对维持性血液透析(MHD)患者体内同型半胱氨酸(Hcy)及C-反应蛋白(CRP)水平的影响。方法选取2013年蚌埠市第一人民医院MHD患者60例,按不同的血液净化方式分为单纯血液透析组(HD组)、血液透析滤过组(HD+HF组)、血液透析灌流组(HD+HP组),另选健康者作为健康对照组,每组20例。分别于治疗前、治疗后1 d及治疗后12周检测各组血清Hcy及CRP的水平。结果 MHD患者血清Hcy、CRP水平明显高于健康对照组(P<0.01),HD+HF组和HD+HP组治疗后Hcy水平均显著下降(P<0.01),治疗后12周HD+HP组CRP下降明显(P<0.05)。结论 HD+HF及HD+HP治疗可使MHD患者血清同型半胱氨酸及CRP水平下降,可能有助于降低尿毒症患者心脑血管疾病的发病率。

Objective To observe the effects of different blood purification on the serum homocysteine（Hcy）and C reactive protein（CRP）levels of patients undergoing maintenance hemodialysis（ MHD）. Methods A total of 60 MHD patients were selacted and equally divided into three groups：hemodialysis group（HD group）,hemodialysis ＋ hemodiafiltration group（HD ＋HDF group）,hemodialysis ＋ hemoperfusion group（HD ＋ HP group）according to their different blood purification modes. Anoth-er 20 healthy subjects were chosen served as control group. The seurm levels of Hcy and CRP were detected pre the treatment, one day and 12 weeks after treatment in the three groups. Results The levels of Hcy and CRP in MHD patients were significant-ly higher than those in the healthy controls（P 〈 0. 01）. After 12 weeks treatment,the seurm levels of CRP in the HD ＋ HP group were lower than others（P 〈 0. 05）. Conclusion HD ＋ HF and HD ＋ HP can reduce the seurm levels of Hcy and C-reative pro-tein effectively,and may reduce cardiocerebrovascular diseases rate of MHD patients.