血液灌流联合血液透析对维持性血液透析患者IL-6、TNF-α、hs-CRP及Hcy等指标水平的影响

Influence of Hemoperfusion Combined with Hemodialysis on IL-6, TNF-α,hs-CRP and Hcy of Patients Undergoing Maintenance Hemodialysis

目的:研究血液灌流联合血液透析对接受维持性血液透析(MHD)的患者白介素-6(IL-6)、肿瘤坏死因子(TNF-α)、超敏C反应蛋白(hs-CRP)及同型半胱氨酸(Hcy)等指标水平的影响。方法:选择2010年5月至2013年5月在我院接受MHD的终末期肾病112例作为研究对象。根据数字法随机分成观察组及对照组,每组均含56例患者。对照组行常规血液透析治疗,观察组行血液灌流及血液透析的联合治疗。治疗12周后对比分析两组治疗前后的各项炎性因子与营养学指标,及生活质量指数(QOL)评分。结果:治疗后观察组的hs-CRP、IL-6及TNF-α与Hcy水平均显著低于对照组,差异均有统计学意义(均P<0.05)。治疗后观察组的血清Hb、TP及Alb与TRF水平均显著高于对照组,差异均有统计学意义(均P<0.05)。两组治疗后的QOL评分较治疗前均显著上升,但观察组的上升幅度显著大于对照组,差异均有统计学意义(均P<0.05)。结论:血液灌流与血液透析联合治疗接受MHD的患者,可有效改善患者机体的微炎症及营养状况,提升患者的生活质量,效果明显,值得临床推荐。

Objective： To study the influence of hemoperfusion combined with hemodialysis on the levels of IL-6,TNF-α, hs-CPP and Hey of patients undergoing maintenahce hemodialysis. Methods： A total of 112 patients with end-stage renal disease, who were treated with maintenance hemodialysis （MHD） in Suining Central Hospital from May 2010 to May 2013, were chosen as the study subjects and randomly divided into observation group （n=56） and control group （n=56）. The control group was treated with hemodialysis, and the ob： servation group was treated with hemoperfusion combined with hemodialysis. After 12 weeks, the indexes of inflammatory factors, nutrition and the quality of life （QOL） scores of the two groups before and after treatment were compared and analyzed. Results： The levels of hs-CRP, IL-6, TNF-α and Hey of observation group were significantly lower than those of control group after treatment, the differences were statistically significant （P〈0.05）. The levels of Hb, TP and Alb and TRF of observation group were significantly higher than those of control group after treatment, the differences were statistically significant （P〈0.05）. Compared with before treatment, the QOL scores of two groups after treatment significantly increased, but the QOL scores of observation group was significantly higher than those of control group, the differences were statistically significant （P〈0.05）. Conclusion： Hemoperfusion combined with hemodialysis can effectively improve the micro inflammation and nutrition of the patients undergoing MHD, which enhances the QOL of patients and is wor- thy of the clinical application.