中国血液净化

›› 2010, Vol. 9 ›› Issue (12): 672-674.doi: 10.3969/j.issn.1671-4091.2010..00

• 临床研究 • 上一篇    下一篇

血液透析联合血液灌流对维持性血液透析患者微炎症与 营养状况的影响

胡杨青 颜伟健 周巧玲   

  1. 邵阳医专附属医院肾内科,中南大学湘雅医院肾内科
  • 收稿日期:2010-07-15 修回日期:1900-01-01 出版日期:2010-12-12 发布日期:2010-12-12

Effect of hemodialysis combined with hemoperfusion on inflammation and nutrition status in maintenance hemodialysis patients

HU Yang-qing, YAN Wei-jian, ZHOU Qiao-ling   

  1. 1Department of Kidney, Affiliated Hospital of Shaoyang Medical College, Shaoyang 422000, China; 2Department of Nephrology, Xiangya Hospital of Central South University, Changsha 410008, China
  • Received:2010-07-15 Revised:1900-01-01 Online:2010-12-12 Published:2010-12-12

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摘要： 目的 探讨血液透析(hemodialysis,HD)联合血液灌流(hemoperfusion,HP)对维持性HD患者微炎症和营养状况的影响。方法 选择维持性HD的终末期肾病患者40例，随机分为2组：HD联合HP组(HD+HP组)和单纯HD组(HD组)，每组各20例，分别于治疗前和治疗3个月后采血，全自动生化仪检测血红蛋白(hemoglobin,Hb)、血清白蛋白(albumin,Alb)、转铁蛋白(transferrin,TRF)、C反应蛋白(C-reactive protein,CRP)，放射免疫法检测血浆瘦素(leptin)、肿瘤坏死因子 (tumor necrosis factor- ,TNF- )水平。结果 ①HD组与HD+HP组患者治疗前血CRP、leptin、TNF-帷b、Alb和TRF差异均无统计学意义(P＞0.05)。治疗后，HD组患者CRP、leptin和TNF-崴浇现瘟魄拔廾飨愿谋 (P＞0.05)；HD+HP组治疗后血CRP明显下降(P＜0.05)，leptin和TNF-崴浇现瘟魄熬档 (P＜0.01)。②HD组治疗后较治疗前Hb升高(P＜0.01)，Alb升高(P＜0.05)，TRF与治疗前比较则差异无统计学意义(P＞0.05)；HD+HP组治疗后Hb、Alb和TRF均升高(P＜0.01)。③HD+HP组治疗后Hb、Alb和TRF升高幅度较HD组明显(P＜0.05)，CRP、leptin和TNF-嵯陆捣冉螲D组大(P＜0.01)。结论 HD联合HP治疗终末期肾病HD患者可有效清除中大分子炎症因子，改善HD患者的贫血和营养状况。

关键词: 血液灌流, 血液透析, 微炎症, 营养

Abstract: Objective To study the effect of hemodialysis (HD) combined with hemoperfusion (HP) on microinflammation and nutrition status in maintenance hemodialysis patients. Methods We collected 40 end-stage renal disease (ESRD) patients on hemodialysis, and randomly divided them into two groups: hemoperfusion combined with hemodialysis group (n=20, HP+HD group) and simple hemodialysis group (n=20, HD group). Before and after the treatment for 3 months, hemoglobin (Hb), and serum albumin (Alb), transferrin (TRF) and C-reactive protein (CRP) were measured on a biochemistry analyzer, and plasma leptin and tumor necrosis factor-&#61537; (TNF-&#61537;) were determined by radioimmunoassay. Results No significant differences in CRP, leptin, TNF-&#61537;, Hb, Alb and TRF were found between the 2 groups before treatment (P>0.05). However, CRP, leptin and TNF-&#61537; significantly decreased after the treatment in HD+HP group (P<0.05) but not in HD group. Hb and Alb significantly increased after the treatment in the 2 groups (P<0.05). TRF increased after treatment only in HD+HP group (P<0.01). After the treatment, Hb, Alb and TRF were higher in HD+HP group than in HD group (P<0.05), and CRP, leptin and TNF-&#61537; were lower in HD+HP group than in HD group (P<0.01). Conclusion HD combined with HP is an effective method to remove increased inflammation factors and to improve anemia and nutrition status, and is therefore beneficial to their living quality and life span.

Key words: Hemodialysis, Microinflammation, Nutrition