血液透析与腹膜透析对终末期肾病患者血脂、氧化应激及炎症因子的影响

Effects of Hemodialysis and Peritoneal Dialysis on Lipids,Oxidative Stress and Inflammatory Factors in Patients with End-stage Renal Disease

目的探讨对终末期肾病予血液透析和腹膜透析治疗对血脂、氧化应激及炎症因子水平的影响。方法方便选择2021年3—12月仪征市人民医院收治的终末期肾病患者120例,以随机数表法分为对照组(血液透析,n=60)和观察组(腹膜透析,n=60),检测治疗前后两组总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)评估血脂水平,检测治疗前后两组丙二醛(MDA)、超氧化物歧化酶(SOD)、髓过氧化物酶(MPO)水平评估机体氧化应激反应状态,检测治疗前后两组血清C反应蛋白(CRP)、白介素IL-6、IL-8评估炎症反应状态,统计两组并发症发生率。结果治疗后,观察组TC(6.30±0.3)mmol/L、TG(2.79±0.12)mmol/L、LDL-C(3.85±0.25)mmol/L均高于对照组,差异有统计学意义(t=6.702、10.820、7.789,P<0.05);观察组MDA(9.33±1.08)nmol/L、MPO(7.34±0.67)U/L均低于对照组,SOD(148.25±16.53)U/mL高于对照组,差异有统计学意义(t=6.892、6.706、5.070,P<0.05);观察组CRP(8.06±2.41)mg/L、IL-6(31.67±3.87)ng/L、IL-8(105.71±7.15)ng/L均低于对照组,差异有统计学意义(t=6.766、4.853、6.424,P<0.05)。观察组并发症发生率低于对照组(8.33%vs 23.33%),差异有统计学意义(χ^(2)=5.065,P<0.05)。结论对终末期肾病患者予腹膜透析能减轻氧化应激与炎症反应,且可降低并发症风险,但容易导致血脂代谢紊乱。

Objective To investigate the effects of hemodialysis and peritoneal dialysis on the levels of lipids,oxida⁃tive stress and inflammatory factors in patients with end-stage renal disease.Methods 120 patients with end-stage re⁃nal disease admitted to the Yizheng People′s Hospital from March to December 2021 were conveniently selected and divided into control group(hemodialysis,n=60)and observation group(peritoneal dialysis,n=60)by random number table.Total cholesterol(TC),triglycerides(TG),and low-density lipoprotein(LDL-C)were measured before and after treatment of two groups to assess lipid levels.Malondialdehyde(MDA),superoxide dismutase(SOD),and myeloperoxi⁃dase(MPO)levels were measured to assess the oxidative stress response status of the body of two groups before and af⁃ter treatment.Serum C-reactive protein(CRP),interleukin IL-6 and IL-8 were also measured to assess the inflamma⁃tory response status,and the complication rates of the two groups were also counted for comparison.Results After treatment,TC(6.30±0.3)mmol/L,TG(2.79±0.12)mmol/L and LDL-C(3.85±0.25)mmol/L in the observation group were higher than in the control group,the difference was statistically significant(t=6.702,10.820,7.789,P<0.05);MDA(9.33±1.08)nmol/L,MPO(7.34±0.67)U/L in the observation group were lower than the control group,and SOD(148.25±16.53)U/mL was higher than the control group,the difference was statistically significant(t=6.892,6.706,5.070,P<0.05);CRP(8.06±2.41)mg/L,IL-6(31.67±3.87)ng/L,IL-8(105.71±7.15)ng/L in the observation group were lower than those in the control group,the difference was statistically significant(t=6.766,4.853,6.424,P<0.05).The complication rate in the observation group was lower than that in the control group(8.33%vs 23.33%),the differ⁃ence was statistically significant(χ^(2)=5.065,P<0.05).Conclusion Peritoneal dialysis in patients with end-stage renal disease reduces oxidative stress and inflammatory response and may reduce the risk of complications,but is prone to disorders of lipid metabolism.