血液透析联合血液透析滤过对患者营养及微炎症指标的影响

Influence of Hemodialysis Plus Hemodiafiltration on Nutrition Status and Microinflammation of Patients Undergoing Maintenance Hemodialysis

目的:探讨血液透析(HD)联合血液透析滤过(HDF)对维持性血液透析(MHD)患者营养及微炎症指标的影响。方法:选择2005年12月到2014年12月在我院接受治疗的140例MHD患者,随机分为HD组(n=70)和HD+HDF组(n=70)。比较两组患者治疗前后营养不良-炎症评分(MIS)、C反应蛋白(CRP)、白细胞介素6(IL-6)、白蛋白(ALB)、前白蛋白(PA)、血红蛋白(Hb)、握力(HS)、肱三头肌皮褶厚度(TSF)的变化。结果:治疗后,HD+HDF组患者MIS明显降低,ALB、PA、Hb、HS、TSF明显升高(均P<0.05),且各指标改善程度均优于HD组(均P<0.05);治疗后,HD+HDF组患者相比于治疗前和HD组治疗后,CRP、IL-6明显降低(均P<0.05)。结论:HD联合HDF较单纯HD能更好的改善患者营养状态,减轻微炎症反应。

Objective： To investigate the influence of hemodialysis（HD） combined with hemodiafiltration（HDF） on nutrition status and microinflammation in maintenance hemodialysis（MHD）patients. Methods： A total of 140 patients, who underwent MHD in Changhai Affiliated Hospital of Second Military Medical University from December 2005 to December 2014, were selected and randomly divided into HD group（n=70） and HD＋HDF group（n=70）. Then the malnutrition inflammation score（MIS）,C-reactive protein（CRP）, interleukin-6（IL-6）, serum albumin（ALB）, prealbumin（PA）, hemoglobin（Hb）, handgrip strength（HS）, brachial, three triceps skinfold thickness（TSF）before and after treatment were compared in the two groups. Results： After treatment, in HD＋HDF group MIS was significantly reduced and ALB, PA, Hb, HS, TSF significantly increased, and the improvement in HD＋HDF group was significantly better than HD group（P〈0.05）; CRP and IL-6 were significantly lower than before treatment and HD group after treatment（P〈0.05）. Conclusion： Hemodialysis plus hemodiafiltration can improve the nutrition status and reduce microinflammation, better than hemodialysis alone for MHD patients.