不同血液净化模式对维持性血液透析患者血清内脏脂肪素的影响

目的 探讨不同血液净化模式对维持性血液透析患者(MHD) 内脏脂肪素(visfatin)表达水平的影响。方法 选择规律血液透析患者60例,并选取健康对照组60例,观察患者血清内脏脂肪素的表达水平及与微炎症状态的关系,随后将60例患者随机分为血液透析组(HD)、血液灌流+血液透析组(HD+HP)和血液透析滤过组(HDF)3组,观察三种治疗模式单次治疗4 h后、连续治疗3个月后与治疗前内脏脂肪素的表达水平及清除率。结果 维持性血液透析患者内脏脂肪素水平明显高于健康对照组,内脏脂肪素表达水平与IL-6、超敏C-反应蛋白(Hs-crp)呈明显正相关,HD组治疗前后血清visfatin无明显变化,HDF、(HD+HP)组治疗前4 h及3个月后血清visfatin均明显降低,差异有统计学意义,(HD+HP)组清除率大于HDF组,差异有统计学意义。结论 血液透析患者血清内脏脂肪素明显升高,与患者微炎症状态明显相关,血液透析滤过与血液灌流均能清除内脏脂肪素,血液灌流效果优于血液透析滤过,血液透析无法清除内脏脂肪素。

Effect of different blood purification modes on serum visfatin of patients with maintenance hemodialysis

Objective To investigate the effect of different blood purification modes on serum visfatin of patients with maintenance hemodialysis (MHD). Methods Sixty cases of patients with regular hemodialysis were selected, and 60 cases of healthy were selected as control group. The expression level of visfatin in serum and its relationship with microinflammation were observed. Then 60 cases were randomly divided into hemodialysis group (HD), hemoperfusion+hemodialysis group (HD+HP) and hemodialysis filtration group (HDF). The level of visceral adiponectin expression and clearance rate after 4 hours of single therapy, 3 months of continuous treatment and before treatment in the treatment mode were observed. Results The visfatin level of MHD was significantly higher than that in healthy control group. The visfatin expression level was positively correlated with IL-6 and Hs-crp. There was no significant change in serum visfatin before and after treatment in HD group. The visfatin levels in HDF and (HD+HP) groups decreased significantly 4 hours before and 3 months after treatment, and the difference was statistically significant. The clearance rate of (HD+HP) group was higher than that of HDF group. Conclusion Serum visceral visfatin of MHD is significantly increased, which is significantly correlated with microinflammation. Both hemodiafiltration and hemoperfusion can remove visceral visfatin. The effect of hemoperfusion is better than that of hemodiafiltration, and hemodialysis can not remove visceral visfatin.