高通量血液透析对终末期肾病患者微炎性状态及细胞免疫的影响分析

Effect of high throughput hemodialysis on inflammatory state and cellular immunity in patients with end-stage nephropathy

目的探讨高通量血液透析(HFHD)在改善终末期肾病患者炎症状态及细胞免疫中的应用效果。方法选取2017年12月至2020年12月南阳市南阳宝树透析中心收治的136例终末期肾病患者,按照透析方式的不同分为HFHD组76例和常规血液透析(CHD)组60例。两组透析3个月后评估其治疗效果,比较治疗前后微炎性状态[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6),C反应蛋白(CRP)]、细胞免疫功能[CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)]的变化情况。结果与CHD组相比,HFHD组治疗后临床疗效更高(89.47%vs.70.00%),差异有统计学意义(P<0.05)。与CHD组相比,HFHD组透析3个月后IL-6、CRP、TNF-α降低程度更好,CD4^(+)、CD4^(+)/CD8^(+)升高程度更好,且CD8^(+)降低程度更好,差异有统计学意义(P<0.05)。结论HFHD在改善终末期肾病患者微炎性状态及细胞免疫方面的效果优于CHD,患者能够获得更为满意的治疗效果。

【Objective】To investigate the effect of high-throughput hemodialysis in improving the inflammatory state and cellular immunity in patients with end-stage nephropathy.【Methods】A total of 136 patients with end-stage nephropathy were selected from December 2017 to December 2020.They were divided into high-throughput hemodialysis(HFHD)group with 76 cases and conventional hemodialysis(CHD)group with 60 cases according to the different methods of hemodialysis.After dialysis for 3 months,the therapeutic effect was evaluated,and the changes of the inflammatory state(TNF-α,IL-6,CRP),cellular immunity function(CD 4^(+),CD 8^(+),CD 4^(+)/CD 8^(+))were compared before and after treatment.【Results】Compared with CHD group,the clinical effect of HFHD group was higher(89.47%vs.70.00%),and the difference was statistically significant(P<0.05).Compared with CHD group,the reduction of IL-6,CRP,TNF-αwas better in HFHD group after 3 months dialysis,the level of CD 4^(+),CD 4^(+)/CD 8^(+)increased,the degree of CD 8^(+)decreased better,and the difference was statistically significant(P<0.05).【Conclusion】High throughput hemodialysis is better than that of conventional hemodialysis in improving the inflammatory state and cellular immunity of patients with end-stage nephropathy,and can obtain more satisfactory therapeutic effect.