超纯透析液对血液透析患者外周血炎性细胞因子及血管硬化水平的影响

Influence of ultrapure dialysate on peripheral blood inflammatory cytokines and vascular sclerosis levels of hemodialysis patients

目的观察超纯透析液对血液透析患者外周血炎性细胞因子及血管硬化水平的影响。方法选择该院收治的血液透析患者96例为研究对象,按照随机数字表法分为研究组与对照组各48例,两组均给予维持性血液透析治疗,对照组采用标准透析浓缩液,研究组采用超纯透析浓缩液,两组均持续治疗6个月。检测两组透析液中内毒素、细菌DNA片段水平,比较两组治疗前后外周血炎性细胞因子及血管硬化水平。结果研究组透析液中DNA水平显著低于对照组(P<0.05),经细菌16S-tRNA引物扩增后电泳灰度值显著低于对照组(P<0.05)。研究组透析液中内毒素水平显著低于对照组(P<0.05)。治疗后,对照组外周血超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)水平较治疗前差异无统计学意义(P>0.05),研究组外周血hs-CRP、TNF-α、IL-1β、IL-6水平均显著低于治疗前与对照组(P<0.05)。治疗后,对照组踝-臂脉搏传导速度(baPWV)、颈总动脉内-中膜厚度(CA-IMT)较治疗前差异无统计学意义(P>0.05),研究组baPWV、CA-IMT显著低于治疗前与对照组(P<0.05)。结论超纯透析液可显著降低血液透析患者外周血炎性细胞因子水平,减轻血管硬化水平。

Objective To explore the influence of ultrapure dialysate on peripheral blood inflammatory cytokines and vascular sclerosis levels of hemodialysis patients.Methods Totally 96 cases of hemodialysis patients treated in our hospital were selected as the study objects,and were divided into study group and control group according to random number table method,48 cases in each group.All the two groups were given maintenance hemodialysis treatment.The control group were given standard dialysis concentrate,and the study group were given ultrapure dialysis concentrate,all treated for 6 months.Endotoxin in dialysate,bacterial DNA fragment levels were detected,and peripheral blood inflammatory cytokines and vascular sclerosis levels were compared before and after treatment in the two groups.Results DNA concentration in the study group was lower than that in the control group(P<0.05),and after amplification by bacterial 16S-tRNA primers,electrophoretic gray value was significantly lower than that of the control group(P<0.05).The level of endotoxin in the dialysate of the study group was lower than that of the control group(P<0.05).After treatment,there were no significant differences in peripheral blood high sensitive C reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6)levels in the control group when compared with those before treatment(P>0.05),and those in the study group were significant lower than those before treatment or in the control group when compared with those before treatment(P<0.05).After treatment,there was no significant change in ankle brachial pulse conduction velocity(baPWV)and common carotid artery medial thickness(CA-IMT)in the control group when compared with those before treatment(P>0.05),and baPWV and CA-IMT in the study group were significantly higher than those before treatment or in the control group(P<0.05).Conclusion Ultrapure dialysate can significantly reduce peripheral inflammatory cytokine levels of hemodialysis patients,and reduce the level of vascular sclerosis.