前列地尔联合HFHD对慢性肾衰竭患者肾脏血流动力学、肾功能及氧化应激反应的影响

Effects of alprostadil with high-flux hemodialysis on renal function and and oxidative stress in chronic renal failure patients

目的探究前列地尔联合高通量血液透析(HFHD)治疗对慢性肾衰竭患者肾血流动力学、肾功能及氧化应激指标的影响。方法慢性肾衰竭患者104例随机均分为透析组和观察组;透析组患者接受HFHD治疗,观察组使用前列地尔联合HFHD治疗;于入院时、治疗结束1周后,采用彩色多普勒超声检测两组患者肾血流动力学状况,全自动生化分析仪检测血清尿素氮(BUN)、胱抑素C(Cys-C)水平、血钙及血磷水平,化学发光法检测α-平滑肌肌动蛋白(α-SMA)和转化生长因子-β1(TGF-β1)水平,流式细胞术检测T淋巴细胞亚群CD3^(+)及CD4^(+)水平,免疫透射比浊法检测晚期糖基化终产物(AGEs)和总抗氧化能力(TAOC)水平,酶联免疫吸附试验法检测淀粉样蛋白A(SAA)和白细胞介素-13(IL-13)水平。结果治疗结束后1周时,观察组BUN、Cys-C水平、阻力指数、血磷水平、α-SMA、TGF-β1、AGEs、TAOC、SAA及IL-13水平均低于透析组,肾血流量、血钙水平、CD3^(+)与CD4^(+)比例及治疗有效率均高于透析组,差异有统计学意义(P<0.05)。结论前列地尔联合HFHD治疗慢性肾衰竭,可有效改善患者的肾功能、纤维化状况及血流动力学,其机制可能与联合治疗减轻氧化应激和炎症反应有关。

Objective To evaluate the effects of alprostadil combined with high-flux hemodialysis(HFHD)on renal hemodynamics,function,and oxidative stress in chronic renal failure patients.Methods A total of 104 patients with chronic renal failure were included,and randomly divided into a dialysis group and an observation group.The dialysis group received high-flux hemodialysis(HFHD)treatment,while the observation group received alprostadil in combination with HFHD.Assessments were conducted at admission and one week post-treatment.Renal hemodynamics were evaluated using color Doppler ultrasound.Serum levels of urea nitrogen(BUN),cystatin C(Cys-C),calcium,and phosphorus were measured using an automated biochemical analyzer.α-smooth muscle actin(α-SMA)and transforming growth factor-β1(TGF-β1)levels were determined by chemiluminescence.T lymphocyte subsets CD3^(+)and CD4^(+)were analyzed by flow cytometry.Advanced glycation end products(AGEs)and total antioxidant capacity(TAOC)were assessed using immune transmission turbidimetry.Serum amyloid A(SAA)and interleukin-13(IL-13)levels were measured by enzyme-linked immunosorbent assay.Results One week after treatment,the observation group showed significantly lower levels of BUN,Cys-C,resistance index,blood phosphorus,α-SMA,TGF-β1,AGEs,TAOC,SAA,and IL-13 compared to the dialysis group.Conversely,renal blood flow,blood calcium levels,CD3^(+)and CD4^(+)proportions,and treatment efficacy were significantly higher in the observation group(P<0.05).Conclusion Alprostadil combined with HFHD effectively improves renal function,fibrosis status,and hemodynamics in chronic renal failure patients.The mechanism may involve reduced oxidative stress and inflammatory response.