血液灌流联合血液透析对慢性肾衰竭患者炎性指标及同型半胱氨酸、甲状旁腺素、β_2-微球蛋白的影响研究

Study on the influence of hemoperfusion combined with hemodialysis for the inflammatory indexes and Hcy, PTH, β_2-MG of patients with chronic renal failure

目的探讨血液灌流联合血液透析对慢性肾衰竭患者炎性指标及同型半胱氨酸（Hcy）、甲状旁腺素（PTH）、β2微球蛋白（β2-MG）的影响程度。方法将2012年9月-2014年5月西电集团医院收治的58例慢性肾衰竭患者遵循随机分配的原则分为对照组（血液透析组）和观察组（血液灌流联合血液透析组）,各29例。对两组患者治疗前及治疗后4、8、12周时的血清炎性指标及Hcy、PTH、β2-MG水平进行分别检测及比较。结果两组患者治疗前血清白介素（IL）-1β、IL-6、IL-8、IL-10、C反应蛋白（CRP）、肿瘤坏死因子α（TNF-α）、γ干扰素（IFN-γ）、降钙素原（PCT）、Hcy、PTH、β2-MG水平比较差异均无统计学意义（均P〉0.05）,而治疗后4、8周及12周观察组上述指标检测水平均好于对照组,差异均有统计学意义（均P〈0.05）。结论血液灌流联合血液透析对慢性肾衰竭患者炎性指标及Hcy、PTH、β2-MG的影响较为突出,对于慢性肾衰竭患者的炎症状态及其他疾病指标均发挥着积极的改善作用。

Objective To investigate and observe the influence degree of hemoperfusion combined with hemodialysis for the inflammatory indexes and homocysteine（Hcy）, parathyroid hormone（PTH）, β2-microglobulin（β2-MG） of patients with chronic renal failure. Methods Fifty eight patients who were diagnosed as chronic renal failure in Xi＇an XD Group Hospital from September 2012 to May 2014 were divided into control group（hemodialysis group） and observation group（hemoperfusion combined with hemodialysis group） according to the principle of random allocation, with 29 cases in each group. The serum inflammatory indexes and Hcy, PTH, β2-MG of two groups before treatment and at forth, eighth and twelfth week after treatment were respectively detected and compared. Results The inflammatory indexes including the IL-1β, IL-6, IL-8, IL-10, CRP, TNF-α, IFN-γ, PCT, Hcy, PTH, β2-MG of the two groups before treatment had no significant differences（all P 〉0.05）, while the detection levels of observation group at forth, eighth and twelfth week after treatment were all better than the indexes levels of control group, the differences of the indexes levels between the two groups after treatment were all significant（P 〈0.05）. Conclusion The influence of hemoperfusion combined with hemodialysis for the inflammatory indexes and Hcy, PTH, β2-MG of patients with chronic renal failure is extrusive, and the influence all play an active improvement role for the inflammatory state and other disease indexes of patients with chronic renal failure.