血液灌流对维持性血液透析患者颈动脉硬化的影响

Effect of Hemoperfusion on Carotid Atherosclerosis in Maintenance Hemodialysis Patients

目的:探讨血液灌流(HP)对维持性血液透析(MHD)患者颈动脉硬化的影响。方法:选择本院142例MHD患者,随机分为对照组和治疗组。对照组按常规进行血液透析治疗,治疗组在血液透析基础上加用HP治疗,观察时间为9个月。观察两组患者治疗前后颈动脉内中膜厚度(IMT)及血清C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、甲状旁腺素(iPTH)水平变化。结果:治疗组患者治疗后颈动脉IMT较治疗前明显降低(P<0.05),血清CRP、IL-6、TNF-α及iPTH水平较治疗前明显下降(均P<0.01)。对照组患者颈动脉IMT较治疗前无明显变化,血清CRP、IL-6、TNF-α及iPTH水平较治疗前亦无明显变化(P>0.05)。结论:在常规血液透析基础上应用HP对MHD患者颈动脉硬化有治疗作用。

Objective：To investigate the effect of hemoperfusion（HP）on carotid atherosclerosis in maintenance hemodialysis patients.Methods：142 MHD patients in our hospital were randomly divided into two groups：control group and treatment group.The control group was treated with conventional hemodialysis,and the treatment group was treated with HP on the basis of hemodialysis,the observation time was 9 months.Carotid artery intima-media thickness（IMT）and serum C-reactive protein（CRP）,interleukin 6（IL-6）,tumor necrosis factor-α（TNF-α）,intact parathyroid hormone（iPTH）levels were detected in two groups of patients before and after treatment.Results：The carotid IMT was significantly lower than before treatment in the treatment group（P〈0.05）.Serum CRP,IL-6,TNF-αand iPTH levels were significantly decreased than before treatment（P〈0.01）.There were no obvious changes in carotid IMT in the control group compared with before treatment,and the levels of serum CRP,IL-6,TNF-αand iPTH were not significantly changed compared with those before treatment（P〈0.05）.Conclusion：HP can be used to treat carotid atherosclerosis in patients with MHD on the basis of routine hemodialysis.