血液透析和腹膜透析对慢性肾衰竭尿毒症患者微炎症状态的影响及与心血管疾病的关系

目的 探讨血液透析和腹膜透析对慢性肾衰竭（CRF）尿毒症患者微炎症状态的影响及与心血管疾病的关系。方法 选取在本院进行治疗的120例CRF尿毒症患者，根据透析方式的不同分为血液透析组（60例）和腹膜透析组（60例）。治疗6个月后，比较两组患者的C反应蛋白（CRP）、肿瘤坏死因子（TNF）-α、白细胞介素（IL）-1β及IL-6水平。再将两组患者按有无合并慢性心力衰竭（简称心衰）分别分为合并心衰组和无心衰组，分别比较各组患者TNF-α、IL-1β及IL-6水平。结果 治疗前血液透析组和腹膜透析组患者的CRP、TNF-α、IL-1β及IL-6水平比较差异无统计学意义（P>0.05）；治疗后两组患者的TNF-α、IL-1β及IL-6水平较同组治疗前均有降低，且腹膜透析组患者的TNF-α、IL-1β及IL-6水平较血液透析组更低（P均<0.05）。血液透析组和腹膜透析组合并心衰组患者TNF-α、IL-1β及IL-6水平均高于同组无心衰组（P<0.05）。结论 血液透析和腹膜透析均能降低CRF尿毒症患者的TNF-α、IL-1β及IL-6水平，且腹膜透析方式更优，其微炎症状态与心血管疾病相关。

Effect of hemodialysis and peritoneal dialysis on microinflammation of uremia patients in chronic renal failure and its relationship with cardiovascular disease

Objective To explore the effects of hemodialysis and peritoneal dialysis on microinflammation of chronic renal failure（CRF）uremic patients and its relationship with cardiovascular disease.Methods A total of 120 CRF uremic patients treated in our hospital were divided into hemodialysis group(60 cases) and peritonealdialysis group(60 cases) according to the type of dialysis.After 6 months of treatment,the levels of C reactive protein(CRP)，tumor necrosis factor(TNF)-α，interleukin(IL)-1β，IL-6 btween the two groups were compared.Patients in the two groups were divided into the group with and without chronic heart failure(CHF) according to the presence or absence of combined with CHF,the levels of TNF-α、IL-1β，IL-6 in each group were compared.Results There were no significant differences in the levels of CRP,TNF-α,IL-1β，IL-6 between the two groups before treatment(P>0.05).After treatment,the levels of TNF-α,IL-1β，IL-6 in both groups were significantly reduced than the same group before treatment(P<0.05),the levels of TNF-α,IL-1β，IL-6 in the peritoneal dialysis group were lower than those in the hemodialysis group(P<0.05).In patients with CHF,the levels of TNF-α,IL-1β，IL-6 in patients of the group with heart failure were significantly higher than those in the same group of the group without heart failure(P<0.05).Conclusion Both hemodialysis and peritoneal dialysis can reduce the level of TNF-α,IL-1β，IL-6 in CRF uremic patients,and peritoneal dialysis is better.Microinflammation is correlated with cardiovascular disease.