高通量血液透析对糖尿病肾病维持性血液透析患者氧化应激和微炎症状态的影响分析

Effects of High Flux Hemodialysis on Oxidative Stress and Micro Inflammation in Maintenance Hemodialysis Patients with Diabetes Nephropathy

目的探讨高通量血液透析(high flux hemodialysis,HFHD)实行于糖尿病肾病(diabetic nephropathy,DN)患者维持性血液透析中的临床价值。方法选择2021年1月—2022年1月当阳市人民医院收治的82例DN患者为研究对象,以随机数表法分为对照组与观察组,各41例。对照组实行低通量血液透析(low flux hemodi⁃alysis,LFHD),观察组实行HFHD。评估并比较两组氧化应激指标、微炎性因子、免疫功能状态及生活质量。结果治疗前,两组氧化应激指标、微炎症因子水平比较,差异无统计学意义(P>0.05);治疗后,观察组MDA水平高于对照组,SOD、T-AOC、IL-6、TNF-α、CRP水平均低于对照组,差异有统计学意义(P<0.05)。治疗前,两组免疫功能指标比较,差异无统计学意义(P>0.05);治疗后,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均升高,且观察组高于对照组,差异有统计学意义(P<0.05)。治疗前,两组生活质量(SF-36)评分比较,差异无统计学意义(P>0.05);治疗后,两组SF-36评分均明显升高,且观察组高于对照组,差异有统计学意义(P<0.05)。结论实施HFHD可以帮助DN维持性血液透析患者提高机体免疫功能,同时控制机体微炎性反应,降低氧化应激,以提高患者生活质量,取得良好预后结果。

Objective To explore the clinical value of high flux hemodialysis(HFHD)in maintenance hemodialysis for patients with diabetes nephropathy(DN).Methods 82 DN patients admitted to Dangyang People′s Hospital from January 2021 to January 2022 were selected as the study objects,and divided into control group and observation group,with 41 cases in each,the control group received low-throughput hemodialysis(LFHD),and the observation group received HFHD.The oxidative stress index,micro-inflammatory factor,immune function status and the quality of life of the two groups were evaluated and compared.Results Before treatment,the levels of oxidative stress indicators and micro-inflammatory factors in the two groups were compared,the difference was not statistically significant(P>0.05).After treatment,the MDA level of the observation group was higher than that of the control group,and the levels of SOD,T-AOC,IL-6,TNF-α,and CRP were all lower than those of the control group,the difference was statistically significant(P<0.05).Before treatment,the immune function indexes of the two groups were compared,the difference was not statistically significant(P>0.05);after treatment,the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)were increased in two groups,and the observation group was higher those of than the control group,the difference was statistically significant(P<0.05).Before treatment,the quality of life(SF-36)scores between two groups were compared,the difference was not statistically significant(P>0.05),after treatment,the SF-36 scores were significantly increased in two groups,and the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion The implementation of HFHD can help the patients with DN maintenance hemodialysis to improve the immune function of the body,control the microinflammatory reaction of the body,reduce oxidative stress,improve the quality of life of the patients,and achieve good prognosis.