不同透析膜对血透患者血清C-反应蛋白及白细胞介素-6水平的影响

目的:探讨不同透析膜对维持性血液透析患者血清C-反应蛋白(CRP)及白细胞介素-6(IL-6)水平的影响。方法:选取尿毒症透析患者54例,分为醋酸纤维素膜(CA130)组、低通量聚砜膜(F6)组及高通量聚砜膜(F60)组,另选取30例尿毒症非透析患者作为非透析组,30例健康体检者作为正常对照组,监测透析前后患者炎症指标水平的变化。结果:透析组患者透析前及非透析组患者CRP、IL-6水平均较正常对照组显著升高(P<0.01)。F6组及F60组透析后CRP、IL-6水平与透析前相比差异均无统计学意义(P>0.05),CA130组透析后CRP、IL-6水平与透析前相比明显升高(P<0.01)。结论:尿毒症患者存在着微炎症状态,这种炎症状态与透析膜的生物相容性有关,而采用高通量透析器透析并不增加这种炎症反应。

Influence of hemodialysis membrane on serum levels of C-reactive protein and interleukin-6 in hemodialysis patients

Objective To investigate the effect of different hemodialysis membranes on the serum levels of C-reactive protein (CRP) and interleukin-6 (IL-6) in patients on maintenance hemodialysis. Methods Fifty-four uremic patients were randomized to receive hemodialysis with triacetate membrane (CA130), low-flux polysulfone membrane (F6), or high-flux polysulfone membrane (F60). 30 nondialysis patients with uremia were chosen as nondialysis control and 30 healthy individuals were recruited as normal control. Levels of CRP and IL-6 were detected before and after dialysis. Results As compared with those in the normal controls, the levels of CRP and IL-6 were significantly elevated in the predialysis patients and nondialysis patients. There were no significant differences in levels of CRP and IL-6 between the patients dialyzed with F6 and those with F60 and the levels of CRP and IL-6 were markedly increased in those dialyzed with CA130 after hemodialysis. Conclusions A microinflammatory state develops in patients with uremia and is associated with the biocompatibility of different hemodialysis membranes. A high-flux dialyzer, however, does not increase this inflammatory reaction.