高通量血液透析(HFHD)对终末期糖尿病肾病血液透析患者氧化应激及微炎症状态的影响研究

Research on Effect of HFHD on the Oxidative Stress and Microinflammatory State of Patients with Final Stage Diabetic Nephropathy Hemodialysis

目的探究分析将高通量血液透析应用于终末期糖尿病肾病患者的血液透析治疗中,对改善患者自身存在的氧化应激以及微炎症状态所造成的影响。方法选择该院从2014年9月一2017年6月间收治的终末期糖尿病肾病患者26例作为研究对象,按照计算机随机分组方案,将所有患者分为对照组和实验组,每组中均包含13例患者。对照组患者采用普通低通量血液透析进行治疗,而实验组患者则采用高通量血液透析进行治疗,对比两组患者治疗6个月后的血清高敏C反应蛋白(hs-CRP)、白介素6(IL-6)、过氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)的数值。结果试验结果显示,对照组患者血清中的IL-6、hs-CRP、MDA较实验组更高,而SOD、GSH-Px数值明显低于实验组,各数据组间差异有统计学意义(P<0.05)。结论通常情况下终末期糖尿病肾病患者往往比其它原因导致的终末期肾病患者氧化应激反应以及微炎症状态更为明显,如果长期应用低通量血液透析,由于炎症因子清除不充分,则有可能使患者体内的氧化应激水平加重以及炎症因子蓄积。所以在对终末期糖尿病肾病患者进行血液透析治疗时,应当选择高通量血液透析,清除更多炎症因子,能够减轻患者体内的氧化应激反应以及炎性反应,减少不良并发症发生,提高患者生活质量。

Objective To study and analyze the effect of HFHD on the oxidative stress and microinflammatory state of patients with final stage diabetic nephropathy hemodialysis.Methods26cases of patients with final stage diabetic nephropathy admitted and treated in our hospital from September2014to June2017were selected as the research objects and randomly divided into two groups with13cases in each,the control group used the common low flux hemodialysis,while the experimental group used the HFHD for treatment,and the hs-CRP,IL-6,SOD,GSH-Px and MDA were compared between the two groups.Results The test results showed that the serum IL-6,hs-CRP,MDA in the control group were higher than those in the experimental group,and the SOD,GSH-Px values were obviously lower than those in the experimental group,and the differences in various data between groups were statistically significant(P<0.05).Conclusion The oxidative stress and microinflammatory state of patients with final stage diabetic nephropathy hemodialysis in general is more obvious than those of patients with end-stage renal disease caused by other causes,the insufficient clearance of inflammatory factors caused by the long-term application of LFHD may aggravate oxidative stress level and inflammatory factor accumulation,therefore,we should select the HFHD in treatment of final stage diabetic nephropathy hemodialysis thus eliminating more inflammatory factors,reliving the oxidative stress and microinflammatory state,reducing the occurrence of adverse complications,and improving the quality of life.