血液灌流联合血液透析治疗对老年急性肾衰竭病人肾功能和微炎症状态的影响

Influence of hemoperfusion combined with hemodialysis on renal function and slightly inflammatory state in elderly patients with acute renal failure

目的探讨血液灌流(HP)联合血液透析(HD)治疗对老年急性肾衰竭病人肾功能和微炎症状态的影响。方法将86例老年急性肾衰竭病人根据治疗方法的不同分为HD组(n=36)和联合组(n=50),2组病人均给予常规对症处理,在此基础上,HD组病人给予HD治疗,联合组病人给予HP联合HD治疗,检测HD组和联合组病人治疗前后肾功能指标[血尿素氮(BUN)、血肌酐(Cr)]和炎症因子[白细胞介素10(IL-10),白细胞介素1β(IL-1β)、血清淀粉样蛋白A(SAA)]水平并进行比较。结果 HD组和联合组治疗前BUN、Cr水平比较差异无统计学意义(P>0.05);治疗后2组BUN、Cr均较治疗前显著降低,差异有统计学意义(P<0.05),2组间比较差异无统计学意义(P>0.05);HD组治疗后SAA、IL-1β、IL-10与治疗前比较差异无统计学意义(P>0.05),联合组治疗后SAA、IL-1β显著低于治疗前和HD组治疗后,差异有统计学意义(P<0.05),联合组治疗前、后IL-10比较差异无统计学意义(P>0.05)。结论 HP联合HD治疗不仅可以改善老年急性肾衰竭病人肾功能,还可降低炎症反应。

Objective To explore the influence of hemoperfusion （HP） combined with hemodialysis （HD） on renal function and slightly inflammatory state in elderly patients with acute renal failure. Methods Eighty-six elderly patients with acute renal failure were divided into HD group （n = 36） and combination group （n=50） according to treatment method. Patients in two groups were treated with conventional treatment. On this basis, patients in HD group were given HD treatment, while patients in combination group were given HP combined with HD treatment. The levels of blood urea nitrogen （BUN）, serum ereatinine （Cr） and interleukin 10 （IL-10）, interleukin 1β （IL-1β）, serum amyloid A （SAA） were detected in HD group and combination group before and after treatment. Results The levels of BUN, Cr showed no statistical difference between HD group and combination group（P〉0. 05） ; The levels of BUN, Cr in HD group and combination group after treatment were significantly decreased （P〈0. 05）, but showed no statistical difference between two groups （P〉0.05）. The levels of IL-1β, SAA, IL-10 in HD group after treatment had no statistically significant difference with those before treatment （P〉0.05）. The levels of IL-1β, SA in combination group after treatment were significantly lower than those before treatment and those in HD group after treatment （P〈0. 05）, but the level of IL-10 showed no statistical difference in combination group before and after treatment. Conclusions HP combined with HD treatment in the elderly patients with acute renal failure can not only improve the renal function, but also reduce the inflammatory response.