不同血液净化方式对维持性血液透析患者血清炎症因子的影响

目的观察低通量血液透析(LFHD)、高通量血液透析(HFHD)和血液透析滤过(HDF)对维持性血液透析(MHD)患者血清炎症因子的影响。方法选取MHD患者60例,随机分为LFHD组、HFHD组和HDF组各20例,对照组为20名健康体检者,检测透析前后及透析6月血清CRP、IL-6、IL-8及TNF?α水平。结果 MHD患者透析前血清CRP、IL-6、IL-8及TNF?α水平高于对照组(P<0.01)。LFHD组单次和透析6个月后CRP、IL-6、IL-8及TNF?α水平均不降低(P>0.05);HFHD组单次透析后CRP、IL-6、IL-8及TNF?α水平下降不明显(P>0.05),透析6个月后,CRP、IL-6、IL-8及TNF?α水平下降(P<0.05);HDF组单次和透析6个月后CRP、IL-6、IL-8及TNF?α水平下降(P<0.05);透析6个月后,HDF组CRP、IL-6、IL-8及TNF?α水平低于HFHD组同期水平(P<0.05)。结论 MHD患者存在着微炎症状态,HDF和HFHD透析可以降低血清CRP、IL-6、IL-8及TNF?α水平,改善MHD患者微炎症状态,HDF透析优于HFHD。

Effects of Different Blood Purification Methods on Serum Inflammatory Cytokine in Maintenance Hemodialysis Patients

Objective To study the effects of low-flux hemodia｜ysis （LFHD）, high-flux hemodialysis （HFHD and hemodiafihration （HDF） on the serum inflammatory cytokine in maintenance hemodialysis （MHD） patients. Methods Sixty MHD patients were randomly divided into LFHD group, HFHD group and HDF grouF Results The levels of serum CRP, IL-6, IL-8 and TNF-α were detected in three groups and control grouF The results showed that levels of CRP, IL-6, IL-8 and TNF -α in patients with MHD before treatment were muc higher than these in control group （P 〈0.01 ）. The levels of CRP, IL-6, IL-8 and TNF~ did not significantl decrease in patients with LFHD after the first hemodialysis and after the hemodialysis 6 months （ P 〉 0.05 ） The levels of CRP, IL-6, IL-8 and TNF-αdid not significantly decrease in patients with HFHD after the fir hemodialysis （P 〉0.05）. The levels of CRP, IL45, IL-8 and TNF-α decreased markedly in patients with Hi HD after 6 months hemodialysis（P 〈0.05 ）. The levels of CRP, IL-6, IL-8 and TNF-α decreased significant in patients with HDF after the first hemodialysis and after 6 months（P 〈0.05）. The levels of CRP, IL-6, IL- 8 and TNF-α in HDF group were significantly lower than those in HFHD group after 6 months （ P 〈 0.05 ） Conclusion There was microinflammatory state in MHD patients. The lowering of patients＇serum CRP, IL-6 IL-8 and TNF-α levels and thus the recovery from microinflammatory state may be achieved by HDF, HFHD-α and HFHD preferably by HDF.