血液灌流对维持性血液透析患者微炎症状态的影响

目的探讨血液灌流治疗对维持性血液透析患者微炎症状态的影响。方法选择我院血液净化中心维持性血液透析患者60例，随机分为治疗组（男18例、女12例）和对照组（男16例、女14例）。另选择20名健康人作为正常组，监测治疗前后超敏C反应蛋白（hypersensitive C-reactive protein，hs-CRP）、同型半胱氨酸（homocysteine，HCY）、降钙素原（procalcitonin，PCT）以及营养学指标（血浆白蛋白、血浆前白蛋白、血红蛋白）的变化。结果与正常组相比，维持性血液透析患者的炎症因子hsCRP、HCY、PCT水平均显著升高，而血浆白蛋白、前白蛋白、血红蛋白等营养学指标水平均显著降低。血液灌流治疗6周、12周后，治疗组CRP、HCY、PCT水平明显降低，血浆白蛋白、前白蛋白、血红蛋白明显升高，且随着时间延长，变化愈明显。结论血液灌流治疗可降低血hs—CRP、HCY、PCT水平，升高血门蛋白、前白蛋白和血红蛋白水平，显著改善维持性血液透析患者微炎症状态和营养状态。随治疗时间的延长，效果更加明显。

Effects of hemoperfusion on microinflanunation of patients receiving maintenance hemodialysis

Objective To investigate the influence of hemoperfusion on microinflarnmatory state in pa- tients receiving maintenance hemialysis therapy. Methods Sixty patients subject to maintenance hemodialysis in our dialysis center were randomly divided into treatment group（ 18 males and 12 females）and control group（16 males and 14 females）. Twenty normal medical examination adults were selected and served as healthy control group. Patients in treatment group received hemoperfusion（onee per week）and routine hemodialysis（3 times per week）in addition to routine drug therapy for 12 weeks,and those in control group received routine hemodtialysis（3 times per week） in addition to routine drug therapy. Healthy normal controls took no medicines. Serum hs-CRP, HCY, PCF, albumin, prealbumin, and hemoglobin were measured before, and 6 and 12 weeks after treatment. Results As compared with healthy control group, the serum levels of hs- CRP, HCY and PCT were significantly increased, while .serum albumin, prealbumin and hemoglobin levels were significantly reduced in control group. Six and 12 weeks after treatment, the hs-CRP, HCY and PCT levels were obviously decreased in treatment group and control gmup（P〈0. 05）, and albumin, prealbumin and hemoglobin levels were significantly increased （P〈0. 05）. And there was significant difference between treatment group and control group （P〈0. 05）. The longer the duration of the treatment was, the more significant of the changes of all markers were （P〈0. 05）. Conclusions Hemoperfusion can reduce serum levels of hs-CRP, HCY and PCT and increase albumin, prealbumin and hemoglobin levels, and can improve the microinflammatory state in patients subject to maintenance hemodialysis. This effect is more significant along with the prolongation of treatment.