血液透析与血液灌流对终末期糖尿病肾病患者胰岛素抵抗及血清炎症因子水平的影响

Effect of Hemodialysis Plus Hemoperfusion on Insulin Resistance and Serum Inflammatory Factors Levels of Patients with End-stage Diabetic Nephropathy

目的:探讨血液透析联合血液灌流治疗终末期糖尿病肾病的疗效以及对患者胰岛素抵抗及血清炎症因子水平的影响。方法:选择2013年7月-2015年7月在我院接受治疗的100例终末期糖尿病肾病患者作为研究对象。根据治疗方法不同,将所选研究对象分为研究组和对照组。研究组采用血液透析联合血液灌流治疗,对照组采用血液透析联合血液透析滤过治疗。观察并比较两组患者治疗前后胰岛素抵抗程度及血清C反应蛋白(CRP),肿瘤坏死因子-α(TNF-α)及白介素-6(IL-6)水平的变化情况。结果:治疗前,两组患者FBG、FINS、Homa-IR、CRP、TNF-α及IL-6水平比较差异均无统计学意义(P>0.05);与治疗前比较,两组患者治疗后FBG、FINS、Homa-IR、CRP、TNF-α及IL-6水平均显著降低,差异具有统计学意义(P<0.05),且研究组患者治疗后FBG、FINS、Homa-IR、CRP、TNF-α及IL-6水平均明显低于对照组,差异具有统计学意义(P<0.05)。结论:与血液透析联合血液透析滤过方法比较,血液透析联合血液灌流治疗能够更有效的改善ESDN患者胰岛素抵抗程度,降低炎症因子水平,值得临床进一步推广应用。

Objective： To explore the effects of hemodialysis and hemoperfusion on the insulin resistance and serum levels of inflammatory factors of patients with ESDN.Methods： 100 patients with ESDN who were treated in our hospital from July 2013 to July2015 were selected and divided into the study group and the control group according to the different treatment methods.The patients in the study group were treated with hemodialysis and hemoperfusion,while the patients in the control group were treated with hemodialysis and hemodiafiltration.Then the insulin resistance and the serum levels of CRP,TNF-α and IL-6 of patients in the two groups were observed and compared before and after the treatment.Results： There was no statistically significant difference in the FBG,FINS,Homa-IR,serum CRP,TNF-α and IL-6 levels of patients in the two groups（P〉0.05）.After the treatment,the FBG,FINS,Homa-IR,serum CRP,TNF-α and IL-6 levels were lower than before the treatment（P〈0.05）.Compared with the control group,the FBG,FINS,Homa-IR,serum CRP,TNF-α and IL-6 levels in the study group obviously decreased after the treatment（P〈0.05）.Conclusion： Compared with hemodialysis and hemodiafiltration,the hemodialysis and hemoperfusion could more effectively improve the insulin resistance and reduce the inflammatory factors of patients with ESDN,which was worthy of clinical application.