血液灌流联合血液透析对尿毒症患者同型半胱氨酸及炎性因子水平的影响

Effect of Hemoperfusion Combined with Hemodialysis on the Level of Homocysteine and Inflammatory Factors in Uremic Patients

目的探讨血流灌流联合血液透析对尿毒症患者炎性因子及同型半胱氨酸的影响。方法方便选择该院2015年2月—2017年4月收治的120例尿毒症患者为研究对象,根据治疗方法不同分组,观察组与对照组各60例,对照组患者接受血液透析治疗,观察组患者接受血液灌流联合血液透析治疗,对两组患者同型半胱氨酸(Hcy)及炎性因子水平、营养状态等进行观察。结果治疗前,两组患者炎性因子水平差异无统计学意义(P>0.05),观察组治疗后Hs-CRP为(7.21±1.32)mg/L、IL-6为(13.69±1.75)ng/L、TNF-α为(82.01±2.35)ng/L,较治疗前均有下降,对照组上述指标较治疗前上升,两组差异有统计学意义(P<0.05);两组患者治疗前的营养状态、Hcy水平差异无统计学意义(P>0.05),治疗后,观察组Hcy为(17.86±1.04)μmol/L,同对照组比较,明显较低,差异有统计学意义(P<0.05),白蛋白为(36.14±4.58)g/L、前白蛋白为(201.11±10.25)g/L,血红蛋白为(82.68±4.15)g/L,同对照组比较,差异无统计学意义(P>0.05)。结论血液灌流联合血液透析可降低尿毒症患者炎性因子及Hcy水平,也能改善机体营养状态,值得临床推广。

Objective This paper tries to investigate the effect of hemoperfusion combined with hemodialysis on inflammatory factors and homocysteine in patients with uremia.Methods A total of 120 cases with uremia treated in the Third People's Hospital of Haikou City from February 2015 to April 2017 were convenient selected as the research objects,and according to the different treatments,they were divided into observation group and control group and there were 60 cases in each group.The control group received hemodialysis treatment,while the patients in the observation group received hemoperfusion combined with hemodialysis treatment.The levels of homocysteine(Hcy),inflammatory factors and nutritional status in the two groups were observed.Results Before the treatment,there was no significant difference in inflammatory factors between the two groups(P>0.05).After the treatment,Hs-CRP was(7.21±1.32)mg/L,IL-6(13.69±1.75)ng/L,TNF-alpha(82.01±2.35)ng/L in the observation group,which compared with those before the treatment decreased,In the control group,the above indicators increased after the treatment.As a result,the difference between the two groups was statistically significant(P<0.05).There was no significant difference in nutritional status and Hcy level between the two groups before the treatment(P>0.05).But after the treatment,compared with the control group,Hcy was significantly lower(17.86±1.04)mol/L in the observation group.So the difference was statistically significant(P<0.05).Albumin in the observation group was(36.14±4.58)g/L,prealbumin(201.11±10.25)g/L and hemoglobin(82.68±4.15)g/L,and the difference between the observation group and the control group was not statistically significant(P>0.05).Conclusion Hemoperfusion combined with hemodialysis can not only reduce the levels of inflammatory factors and Hcy in uremic patients,but can also improve the nutritional status of the patients,which is worth clinical promotion.