高通量透析联合金水宝片对糖尿病肾病血透患者血管内皮细胞生长因子及白细胞介素1β水平的影响

Effect of High-Throughput Dialysis Combined with Jinshuibao Tablets on Vascular Endothelial Cell Growth Factor and Interleukin 1βLevels in Hemodialysis Patients with Diabetic Nephropathy

目的研究高通量透析与口服金水宝片联合治疗对糖尿病肾透析患者血浆(vasular endothelial growth factor,VEGF)和白细胞介素-1β(interleukin-1β,IL-1β)水平的影响,以期为糖尿病肾透析患者提供新的治疗手段和思路。方法选择2021年1月—2022年6月广东省中西医结合医院收治的80例糖尿病肾病维持性血透患者为研究对象,按照随机数表法分为对照组和观察组,每组40例,两组均为低流量透析。对照组给予高通量透析(HFHD),治疗组在高通量透析的基础上口服金水宝,3片/次(0.42 g/片),3次/d,连续3个月,对比两组研究前后的血红蛋白(Hb)、白蛋白(Alb)、血肌酐(Scr)、尿素氮(BUN)及血浆血管内皮细胞生长因子(VEGF)、白细胞介素-1β(IL-1β)水平。结果治疗前,两组患者BUN、Scr、Hb与Alb水平比较,差异无统计学意义(P>0.05);治疗3个月后,两组患者BUN、Scr水平均降低,Hb和Alb水平均增高,且治疗组的Hb和Alb水平高于对照组,BUN、Scr水平低于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者VEGF、IL-1β水平比较,差异无统计学意义(P>0.05);治疗3个月后,两组患者的VEGF、IL-1β水平均降低,且治疗组VEGF、IL-1β水平低于对照组,差异有统计学意义(P<0.05)。结论高通量透析治疗可改善MHD患者微炎症状态、维护其血管内皮功能,而高通量透析联合金水宝改善更明显。

Objective This study intends to use the combination of high-fluxes hemodialysis and oral Jinshuibao tablets to study the effect of high-fluxes dialysis and oral Jinshuibao tablets on plasma vasular endothelial growth factor(VEGF)and interleukin-1β(IL-1β)levels in diabetic renal dialysis patients,in order to provide new treatment methods and ideas for diabetic renal dialysis patients.Methods The random numbers of 80 patients with diabetic nephropathy maintenance hemodialysis admitted to Guangdong Hospital of Integrated Traditional Chinese and Western Medicine from January 2021 to June 2022 were divided into two groups,both of which were low-flow dialysis.At the beginning of the trial,the control group was given high-fluxes of hemodialysis(HFHD),and the treatment group took 3 tablets(0.42 g/tablet)per day,TID,for three months,hemoglobin(Hb),albumin(Alb),blood creatinine(Scr),urea nitrogen(BUN)(VEGF),interleukin-1β(IL-1β)were compared with high-throughput dialysis.Results The levels of BUN,Scr,Hb and Alb in the blood were not significant before treatment(P>0.05);BUN and Scr decreased significantly 3 months after treatment(P<0.05),Hb and Alb increased significantly 3 months after treatment(P<0.05),and Hb and Alb in the treatment group 3 months after treatment,and BUN and Scr 3 months after treatment(P<0.05).The levels of VEGF and IL-1βin the blood decreased significantly compared with low-throughput dialysis before the trial;VEGF and IL-1βafter 3 months of treatment in the treatment group were more prominent than in the control group(P<0.05).Conclusion High-flux dialysis can improve the micro-inflammatory state of MHD patients and maintain their vascular endothelial function.Highflux dialysis combined with Jinshuibao is more obvious.