血液透析对尿毒症患者免疫功能及血清脂蛋白的影响

Effect of hemodialysiss on immune function and serum lipoprotein in patients with uremia

目的探讨血液透析对尿毒症患者免疫功能及血清脂蛋白的影响。方法选取本院2014年9月-2016年11月进行血液透析的尿毒症患者50例为观察组,同期健康体检者50例为对照组,分别于血液透析前后检测患者肾功能指标:尿素(Urea)、肌酐(Cr)、血尿酸(BUA);免疫功能指标:Ig A、Ig M、Ig G及补体C3、补体C4;脂蛋白相关指标:总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)及脂蛋白a[Lp(a)];并与对照组比较。结果透析前,观察组患者Urea、Cr与BUA水平相比对照组显著升高,而透析后比透析前显著降低,差异均有统计学意义(P<0.05);透析前,观察组患者免疫球蛋白Ig A、Ig M、Ig G及补体C3、C4水平相比对照组显著下降,而透析后比透析前显著升高,差异均有统计学意义(P<0.05);透析前,观察组患者脂蛋白HDL水平显著低于对照组,TC、TG、LDL及LP(a)水平显著高于对照组,而透析后HDL水平显著上升,TC、TG、LDL及LP(a)水平均显著降低,差异均有统计学意义(P<0.05)。结论尿毒症患者出现了肾功能和免疫功能的低下及脂质代谢的紊乱,而血液透析可有效改善尿毒症患者的肾功能,增强免疫功能,减轻尿毒症患者脂代谢紊乱,值得在日后临床实践中推广应用。

Objective To study the effects of hemodialysis on serum lipoprotein and immune function in patients with uremia.Methods Fifty cases of uremia patients with hemodialysis in our hospital were enrolled into the observation group from September 2014 to November 2016,and 50 healthy persons were served as the control group at the same time. The levels of renal function（ Urea,Cr,BUA）,lipoprotein[TC,TG,HDL,LDL,Lp（ a） ],immunoglobulin（ Ig A,Ig M,Ig G and complement C3,complement C4） were measured before and after hemodialysiss,and compared with that of the control group. Results Before hemodialysis,the levels of Urea,Cr and BUA in uremia patients were significantly higher than those in the control group,but decreased significantly after dialysis,and the differences were statistically significant（ P〈0. 05）; before hemodialysis,the levels of Ig A,Ig M,Ig G and complement C3 and complement C4 in observation group were significantly lower than those in the control group,but increased significantly after dialysis,and the differences were statistically significant（ P〈0. 05）; the level of HDL in uremia patients was significantly lower than that in control group,the levels of TC,TG,LDL and LP（ a） were significantly higher than those in control group,while the level of HDL increased significantly after dialysis,and the levels of TC,TG,LDL and LP（ a） significantly decreased after dialysis,with the differences statistically significant（ P〈0. 05）. Conclusion Uremia patients suffered low renal function and immune function and lipid metabolism disorder,and hemodialysis can effectively improve the renal function of patients with uremia,enhance immune function,and reduce lipid metabolism disorders in uremia patients. It is worthwhile in future clinical practice.