不同血液净化方式对维持性血液透析患者微炎症状态及降钙素原的影响

Effects of different blood purification methods on microinflammatory state and procalcitonin in maintenance hemodialysis patients

目的探讨不同血液净化方式对维持性血液透析(MHD)患者机体微炎症状态及降钙素原(PCT)水平的影响。方法MHD患者120例,随机分成血液透析组(HD组)、血液透析联合血液灌流组(HD+HP组)、血液透析联合血液透析滤过组(HD+HDF组)、血液透析联合血液透析滤过及血液灌流组(HD+HDF+HP组),观察12个月,比较组内及组间12个月前、后白细胞介素-6(IL-6)、血沉(ESR)、C反应蛋白(CRP)、PCT水平的变化情况,评价不同血液净化方式对MHD患者微炎症状态及PCT的影响。结果HD+HP组、HD+HDF组、HD+HDF+HP组IL-6、ESR、CRP、PCT水平,与治疗前比较差异均有统计学意义(P<0.05)。HD+HP组治疗12个月后IL-6、CRP、PCT水平优于HD+HDF组、HD+HDF+HP组,其中IL-6下降的程度与HD+HDF组及HD+HDF+HP组比较差异有统计学意义(P<0.05)。结论血液透析联合血液灌流或(和)血液透析滤过的治疗方式可以改善MHD患者的微炎症状态、降低PCT水平;血液透析联合血液灌流在改善MHD患者微炎症状态方面更具优势。

Objective To explore the effects of different blood purification methods on microinflammatory status and procalcitonin(PCT)levels in maintenance hemodialysis(MHD)patients.Methods A total of 120 MHD patients were randomly divided into hemodialysis(HD)group,hemodialysis combined with hemoperfusion(HD+HP)group,hemodialysis combined with hemodiafiltration(HD+HDF)group,hemodialysis combined with hemodiafiltration and hemoperfusion(HD+HDF+HP)group.All groups were observed for 12 months,the changes of interleukin 6(IL-6),blood sedimentation(ESR),C-reactive protein(CRP)and PCT level were compared before and after 12 months of treatment within each group and among groups in order to evaluate the effects of different blood purification methods on microinflammatory status and PCT in MHD patients.Results The levels of IL-6,ESR,CRP and PCT in HD+HP group,HD+HDF group and HD+HDF+HP group were significantly different from those before treatment(P<0.05).The levels of IL-6,CRP and PCT in HD+HP group were better than those in HD+HDF group and HD+HDF+HP group after 12 months of treatment,and the degree of decline of IL-6 was significantly different from that in HD+HDF group and HD+HDF+HP group(P<0.05).Conclusion Hemodialysis combined with hemoperfusion and(or)hemodiafiltration can improve the microinflammatory status of MHD patients and reduce the level of PCT.However,hemodialysis combined with hemoperfusion have more advantages in improving the microinflammatory state.