糖尿病肾病患者高通量血液透析期间免疫功能指标的监测意义分析

Monitoring significance of immune function indexes during high flux hemodialysis in patients with diabetic nephropathy

目的分析低通量与高通量血液透析疗法在糖尿病肾病治疗中对患者免疫功能影响。方法选取2014年5月至2019年5月本院收治的40例糖尿病肾病患者作为研究对象,随机分为对照组与实验组,每组20例。对照组采用低通量血液透析治疗,实验组采用高通量血液透析治疗,比较两组肾功能指标[血肌酐(SCr)、血清尿素氮(BUN)]、免疫功能指标(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、CD8^(+))、炎症指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)]。结果治疗前,两组SCr、BUN水平比较差异无统计学意义;治疗8周后,两组SCr、BUN水平均低于治疗前,且实验组低于对照组,差异有统计学意义(P<0.05)。治疗前,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、CD8^(+)比较差异无统计学意义;治疗8周后,两组CD3^(+)、CD4^(+)/CD8^(+)、CD4^(+)均高于治疗前,CD8^(+)明显低于治疗前,且实验组CD3^(+)、CD4^(+)/CD8^(+)、CD4^(+)均高于对照组,CD8^(+)明显低于对照组,差异有统计学意义(P<0.05)。治疗前,两组TNF-α、IL-6、hs-CRP比较差异无统计学意义;治疗8周后,两组TNF-α、IL-6、hs-CRP均低于治疗前,且实验组低于对照组,差异有统计学意义(P<0.05)。结论高通量血液透析疗法可显著改善糖尿病肾病患者肾功能、T淋巴细胞水平,抑制炎症介质释放,疗效确切,值得临床推广应用。

Objective To analyze the effects of low flux and high flux hemodialysis on the immune function of patients with diabetic nephropa-thy.Methods 40 patients with diabetic nephropathy who were admitted to our hospital from May 2014 to May 2019 were selected as the research subjects,and they were randomly divided into the control group and the experimental group,with 20 cases in each group.The control group was treated with low flux hemodialysis,and the experimental group was treated with high flux hemodialysis,the renal function indexes(serum creatinine[SCr],serum urea nitrogen[BUN]),and immune function indexes(CD3^(+),CD4^(+),CD4^(+)/CD8^(+),CD8^(+)),inflammatory markers(tumor necrosis factor-α[TNF-α],interleukin-6[IL-6],hypersensitive C-reactive protein[hs-CRP])were compared between the two groups.Results Before treatment,there was no significant difference in the levels of SCr and BUN between the two groups;after 8 weeks of treatment,the levels of SCr and BUN in the two groups were lower than those before treatment,and the experimental group was lower than the control group,and the difference was statistically sig-nificant(P<0.05).Before treatment,there was no significant difference in CD3^(+),CD4^(+),CD4^(+)/CD8^(+),CD8^(+)between the two groups;after 8 weeks of treatment,CD3^(+),CD4^(+)/CD8^(+),CD4^(+)in the two groups were higher than before treatment,CD8^(+)was significantly lower than before treatment,and CD3^(+)CD4^(+)/CD8^(+),CD4^(+)in experimental group were higher than the control group,CD8^(+)was significantly lower than the control group,the differ-ence was statistically significant(P<0.05).Before treatment,there was no significant difference in TNF-α,IL-6,hs-CRP between the two groups;af-ter 8 weeks of treatment,TNF-α,IL-6,hs-CRP in the two groups were lower than before treatment,and the experimental group lower than the control group,the difference was statistically significant(P<0.05).Conclusion High flux hemodialysis therapy can significantly enhance renal function and T lymphocyte levels in patients with diabetic nephropathy,and inhibit the release of inflammatory mediators,accurate curative effect,worthy of clinical application.