血液透析联合血液灌流对糖尿病肾病患者微炎症状态的作用

A Controlled Study of Hemodialysis Combined with Hemoperfusion for the Treatment of Micro-inflammation in Diabetic Nephropathy

[目的]探讨血液透析联合血流灌流对糖尿病肾病（DN）患者的疗效及对微炎症的影响。[方法]125例DN患者随机分为两组，观察组（66例）接受血液透析联合血液灌流治疗，对照组（59例）仅接受血液透析治疗。比较两组患者的疗效及微炎症反应结果。[结果]与对照组比较，观察组经治疗后总有效率达60．61％（40／66），明显高于对照组45．76％（27／59）（P〈0．05）；观察组治疗后血清淀粉样蛋白A（SAA）、白介素-6（IL-6）、IL-1β、肿瘤坏死因子α（TNF-α）、转化生长因子-β1（TGF-β1）水平均明显低于对照组，且差异有显著性（P〈0．01）。[结论]血液透析联合血流灌流治疗较之单纯的血液透析治疗对于DN患者有更好的临床效果，同时也可显著改善患者的微炎症状态。

[Objective]The aim of this study was to assess the effect of hemodialysis combined with he- moperfusion for the treatment of microinflammation in diabetic nephropathy patients. [Methods]A total of 125 patients with diabetic nephropathy （DN） were divided into two group randomly. The observation group （ n = 66） received hemodialysis combined with hemoperfusion, and the control group （ n=59） received hemodialy- sis therapy only. The status of curative effect and microinflammation which reflected as serum amyloid A （SAA） ,interleukin-6 （IL-6）,IL-1β,tumor necrosis factor （TNF-α） and transforming growth factor （TGF-131） were compared. [Results]The effective rate of observation group was 60.61%, which was significantly higher than that in control group （45.760%） （ P〈0.05）. After treatment,the levels of SAA, IL-6, IL-1β, TNF-α and TGF-β1 were significantly lower in the observation group than those in the control group. The differences were statistically significant （ P〈0.01）. [Conclusion]Hemodialysis combined with hemoperfusion can effectively decreased microinflammation status in diabetic nephropathy.