血液灌流联合血液透析对患者炎症因子、瘦素及营养状态的影响

目的探讨血液灌流联合血液透析对维持性血液透析(MHD)患者血清炎症因子、瘦素(Leptin)及营养状态的影响。方法选择我院血液净化中心透析龄超过6个月的维持性血液透析患者40例,随机分为血液灌流联合血液透析组(HP+HD)20例和血液透析组(HD)20例。进行为期6个月随访,分别检测治疗前、治疗6个月后患者的血生化指标、瘦素、C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)。结果①6个月后,HP+HD组患者的血红蛋白(Hb)升高(P<0.05),PA和血Alb升高(P<0.01)。②CRP、IL-6、TNF-α较治疗前明显下降(P<0.01)。③血总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和脂蛋白(a)Lp(a)]水平治疗前后差异无统计学意义(P>0.05)。结论 HP+HD可明显改善MHD患者的营养状态,减轻炎症因子的表达。

Effects of hemoperfusion combined with hemodialysis on inflammation factor, Leptin and nutrition status of patients

Objective: To investigate the effects of HP+HD on inflammation factor in patients with MHD.Methods: Forty MHD patients were selected,who had undergone hemodialysis for at least six months before the study.All patients were randomly divided into the HP+HD group(12 males and 8 females) and the HD group(11 males and 9 famales).Serum leptin,hs-CRP,IL-6,TNF-α,sICAM-1,Alb and PA were measured at the experiment onset and 6 months later.Results: The average serum level of albumin and pre-albumin were elevated after six months’ treatment.The average serum level of C-reactive protein(C-RP),interleukin 6(IL-6),tumor necrosis factor-α(TNF-α) and sICAM-1 were significantly lower than those of baseline(P<0.01).Difference was not significant between serum lipid parameters before and after the treatment(P>0.05).Conclusion: HP+HD in MHD patients appear to be associated with the improvement of nutrition and microinflammation