不同血液净化方式对尿毒症患者血清C反应蛋白、白介素-6、血红蛋白及血浆白蛋白水平的影响

Influence of different blood purification measures on C reactive protein,interleukin-6,hemoglobin and plasma albumin levels in patients with uremia

目的探讨不同血液净化方式对尿毒症患者血清C反应蛋白（CRP）、白介素-6（IL-6）、血红蛋白（Hb）及血浆白蛋白（Alb）水平的影响。方法选取2014年1~12月于我院行维持性血液透析治疗的尿毒症患者54例,将其随机分为血液透析治疗组（HD组）、血液透析滤过治疗组（HDF组）及血液透析联合血液灌流治疗组（HD＋HP组）,每组18例。观察三组患者治疗前后血CRP、IL-6、Hb、Alb、钙、磷、甲状旁腺激素（PTH）指标的变化。结果治疗前三组患者各项指标差异无统计学意义（P〉0.05）;治疗后HDF组及HD＋HP组患者血CRP、IL-6、磷、PTH指标较治疗前明显下降,Hb、Alb及钙离子水平明显上升,HD＋HP组血CRP、IL-6及PTH指标较HDF组明显降低,差异均有统计学意义（P〈0.05）。结论维持性血液透析患者存在炎性反应,血液透析滤过及血液灌流治疗可以有效降低维持性血液透析患者的炎性反应,纠正贫血,改善营养状态及钙磷代谢,血液灌流治疗效果更佳。

Objective To discuss the influence of different blood purification measures on C reactive protein（CRP）,interleukin-6（IL-6）,hemoglobin（Hb） and plasma albumin（Alb） levels in patients with uremia. Methods Fifty four patients with uremia treated by maintenance hemodialysis in our hospital from January to December 2014 were selected and randomly divided into hemodialysis group（HD group）,hemodiafiltration group（HDF group）,and hemodialysis combined with hemoperfusion group（HD＋HP group）,with 18 patients in each group.The changes of CRP,IL-6,Hb,Alb,calcium,phosphorus,and parathyroid hormone（PTH） before and after treatment in each group were observed and compared. Results Before treatment,the above indicators among patients in the three groups had no statistically significant difference（P〉0.05）.After treatment,CRP,IL-6,phosphorus,and PTH levels in the HDF group and the HD＋HP group evidently reduced when compared with those before treatment;and Hb,Alb and calcium levels in these two groups markedly increased,CRP,IL-6 and PTH levels in the HD ＋HP group were significantly reduced when compared with those in the HDF group,the differences were statistically significant（P〈0.05）. Conclusion Inflammatory response can be observed in patients treated by maintenance hemodialysis.Hemodiafiltration and hemoperfusion can effectively reduce the inflammatory response in those patients as well as correct anemia and improve state of nutrition and calcium-phosphorus metabolism.Hemoperfusion has a better therapeutic effect.