维持性血液透析患者微炎症与营养状态的相关性分析

Correlation analysis of hemodialysis patients with microinflammation and nutrition status of maintenance

目的探究维持性血液透析患者微炎症与营养状态的相关性。方法选取我院血液透析室及广州医学院第二附属医院血液净化中心2009年2月至2014年2月收治的50例糖尿病肾病患者为研究对象,应用随机平行对照法,将其随机分成常规透析组及联合透析组,另选取暂不需行血液透析治疗的10例糖尿病肾病患者作为一般治疗组,均行微炎症[C-反应蛋白(CRP)、白细胞介素-6(IL-6)]及营养指标[血清白蛋白(Alb)、血红蛋白(Hb)、胆固醇(Ch)、血肌酐(SCr)、尿素氮(BUN)]测定,探讨维持性血液透析患者微炎症与营养状态的相关性。结果治疗3个月后,常规透析组及联合透析组CRP(mg/L:13.78±4.68/9.67±3.22 vs 15.57±3.48)、IL-6(ng/L:27.65±3.45/13.41±7.65 vs 29.56±5.37)、Ch(mmol/L)明显低于一般治疗组(P<0.05),SCr(μmol/L:313.76±51.23/316.45±65.24 vs 310.01±76.21)、Hb(g/L:93.34±14.87/110.23±15.78 vs 87.45±12.68)、Alb(g/L:28.78±5.34/38.73±7.54 vs23.54±4.32)、BUN(mmol/L:12.35±4.45/13.12±5.84 vs 10.56±3.24)显著高于一般治疗组(P<0.05);与常规透析组比较,联合透析组CRP、IL-6、Ch下降幅度及SCr、Hb、Alb、BUN水平上升幅度更高(P<0.05)。结论维持性血液透析患者往往伴有微炎症情况,营养状态的相关性,临床上应引起足够重视。

Objective To explore the correlation between maintenance hemodialysis patients with micro inflammation and nutrition status. Methods Selected 50 cases of diabetic nephropathy patients in ventricular hemodialysis in our hospital and the second affiliated hospital of Guangzhou Medical College from February 2009 to February 2014 in blood purification center as the research object,application of random parallel control method,were randomly divided into the conventional dialysis group and combined hemodialysis group,selected another10 cases of temporarily without diabetic nephropathy patients with hemodialysis as general treatment group underwent micro inflammation,did [C-reactive protein（ CRP）,interleukin-6（ IL-6） ] and nutritional index[serum albumin（ Alb）,hemoglobin（ Hb）,cholesterol（ Ch）,serum creatinine（ SCr）,blood urea nitrogen（ BUN） ]determination,to explore the correlation between maintenance hemodialysis dialysis patients with micro inflammation and nutrition status. Results After 3 months＇ treatment,the conventional hemodialysis group and combined hemodialysis group CRP（ mg / L： 13. 78 ± 4. 68 /9. 67 ± 3. 22 vs 15. 57 ± 3. 48）,IL-6（ ng / L： 27. 65 ±3. 45 /13. 41 ± 7. 65 vs 29. 56 ± 5. 37）,Ch（ mmol / L） was significantly lower than the general treatment group（ P〈0. 05）,SCr（ mol/L： 313. 76 ± 51. 23 /316. 45 ± 65. 24vs310. 01 ± 76. 21）,Hb（ g/L： 93. 34 ± 14. 87 /110. 23 ± 15. 78 vs 87. 45 ± 12. 68）,Alb（ g / L： 28. 78 ± 5. 34 /38. 73 ± 7. 54 vs 23. 54 ± 4. 32）,BUN（ mmol /L： 12. 35 ± 4. 45 /13. 12 ± 5. 84 vs 10. 56 ± 3. 24） was significantly higher than general treatment group（ P〈0. 05）; compared with conventional hemodialysis group,combined with hemodialysis group CRP,IL-6,Ch,Hb,SCr decreased and Alb,BUN levels rise were higher（ P〈0. 05）. Conclusions Patients with maintenance hemodialysis is often associated with micro inflammation,the correlation between nutritional status,clinical attention should be paid.