›› 2005, Vol. 4 ›› Issue (11): 594-596.

• 论著 • 上一篇    下一篇

不同血液净化方法对尿毒症患者血清白介素-6及β2-微球蛋白的影响

尹友生 李小励 韦家智 李康惠 向 清 白先明 唐美媛   

  1. 541001 桂林,桂林医学院附属医院肾内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2005-11-12 发布日期:2005-11-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2005-11-12 Published:2005-11-12

摘要: 目的 探讨不同血液净化方法对尿毒症患者血清白介素-6(IL-6)及β2-微球蛋白(β2-MG)水平的影响。方法 按不同血液净化方式将33例(66次)尿毒症患者随机交叉分为A、B、C、D4 组,用酶联免疫吸附法测定各组净化前后IL-6的浓度并结合β2-MG的浓度及临床情况进行分析。结果 血清IL-6的下降率依次为D>A≈C>B组,血清β2-MG的下降率依次为A>B>D>C组;A、B 2组治疗前后血清IL-6与β2-MG具有显著正相关;B组超滤量明显低于其它各组,但低血压发生率明显高于各组。结论 对血清IL-6及β2-MG的清除作用,高通量聚砜膜F60做血液透析滤过(HDF)明显优于血液透析(HD),AV600s做血液滤过(HF)显著优于HD;F60做HDF及AV600s不论是HF还是HD均有较好的稳定血压作用。而F60做HD较易发生低血压。

关键词: 白介素-6, β2-微球蛋白, 血液透析滤过, 血液滤过, 血液透析, 尿毒症

Abstract: Objective To investigate the infuence of various blood purification methods on the serum interleukin-6 (sIL-6) and beta 2-microglobulin (sβ2-MG) in patients with uremia. Method Thirty-three uremia patients (66 times) purified with various blood purification were methods divided into 4 groups as A、B、C and D by random crossover method. The sIL-6 of 4 groups was measured by enzymelinked immunosorbent assay before and after a blood purification session,and was together analysed with the sβ2-MG and clinical conditions. Results On the reduction of sIL-6 levels were successively D>A≈C>B groups. On the reduction of sβ2-MG levels were successively A>B>D>C groups. Before and after treatment, the sIL-6 level of patients in A and B groups was significantly correlated with sβ2-MG. The ultrafiltration flow rate (UFR) of B group was significantly lower than those of other groups. On incidence of low blood pressure,that in B group was significantly higher than those of other groups. Conclusions On the clearance of sIL-6 and β2- MG, Hemodiafiltration(HDF) using the high-flux polysulfone membranes-F60 were significantly better than hemodialysis(HD)(P<0.001). Hemofiltration using high-flux polysulfone membranes-AV 600s were significantly better than HD(P<0.001). Blood pressure was better steadied by HDF with the F60 and HF and HD with the AV600s, and low blood pressure was likely to occure in by HD with the F60.

Key words: β-microglobulin, Hemodiafiltration, Hemofiltration Hemodialysis, Uremia

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