血液灌流联合血液透析治疗糖尿病肾病患者的效果及对炎症因子、胰岛素抵抗、营养不良状态的影响

Effects of Hemoperfusion Combined with Hemodialysis on Diabetic Nephropathy Patients and Their Effects on Inflammatory Factors,Insulin Resistance and Malnutrition

目的 研究血液灌流联合血液透析治疗糖尿病肾病患者的效果及对炎症因子、胰岛素抵抗、营养不良状态的影响。方法 选取2019年1月—2021年6月来国药重庆西南铝医院就诊的糖尿病肾病患者共70例,随机数表法分组,对照组患者(n=35)应用血液透析进行治疗,观察组患者(n=35)在对照组的基础上应用血液灌流进行治疗,将两组患者在治疗前后炎症因子水平、胰岛功能、氧化应激指标、营养情况和不良反应发生情况进行对比分析。结果 治疗前,两组患者炎症因子和氧化应激指标、胰岛功能、营养情况对比,差异无统计学意义(P>0.05);治疗后,观察组患者炎症因子和氧化应激指标明显优于对照组患者,胰岛功能明显优于对照组患者,营养情况明显优于对照组患者,差异有统计学意义(P<0.05)。观察组患者不良反应发生率为14.29%,较对照组患者的37.14%明显更低,差异有统计学意义(P<0.05)。结论 血液灌流联合血液透析治疗糖尿病肾病能有效改善患者炎症状态,减轻氧化应激反应,恢复胰岛功能,改善营养情况,减少不良反应的发生,值得临床推广。

Objective To study the effect of hemoperfusion combined with hemodialysis on diabetic nephropathy and its effects on inflammatory factors,insulin resistance and malnutrition.Methods A total of 70 patients with diabetic nephropathy who came to Chongqing Southwest Aluminum Hospital from January 2019 to June 2021 were selected and randomly divided into groups.The patients in the control group were treated with hemodialysis,and the patients in the observation group were treated with hemoperfusion on the basis of the patients in the control group.The levels of inflammatory factors,pancreatic islet function,oxidative stress indicators,nutritional status and adverse reactions before and after treatment were compared between the two groups of patients.Results Before treatment,there were no significant differences in inflammatory factors,oxidative stress indexes,islet function and nutrition between 2 groups(P>0.05);after treatment,inflammatory factors and oxidative stress indexes in observation group were significantly better than those in control group,islet function was significantly better than control group,and nutritional status of patients was significantly better than control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in observation group was 14.29%,which was significantly lower than 37.14% in control group,and the difference was statistically significant(P<0.05).Conclusion Hemoperfusion combined with hemodialysis in the treatment of diabetic nephropathy can effectively improve the inflammatory state of patients,reduce oxidative stress,restore islet function,improve nutritional status,and reduce the occurrence of adverse reactions,which is worthy of clinical promotion.