摘要
目的探讨高通量血液透析对非糖尿病维持性血液透析(MHD)患者血清颗粒蛋白前体(PGRN)及胰岛素抵抗的影响。方法入选非糖尿病MHD患者60例,随机分为高通量透析组(n=30)和普通透析组(n=30),同时选择年龄、性别相匹配的20例健康体检者作为对照组。两透析组随访6个月,使用稳态模型胰岛素抵抗指数(HOMA-IR)评估胰岛素抵抗,采用ELISA法测定治疗前后血PGRN、白细胞介素-6(IL-6)水平,并记录超敏C反应蛋白(hs-CRP)、血总钙、血磷、甲状旁腺素(PTH)、血脂、单室模型尿素清除指数(sp Kt/V)等指标的变化。结果与对照组相比,高通量透析组和普通透析组患者HOMA-IR均明显升高(P<0.05)。治疗后高通量透析组的HOMAIR、PGRN、IL-6、hs-CRP、血磷、甘油三酯、总胆固醇较治疗前显著下降(P<0.05),亦明显低于普通透析组(P<0.05)。而普通透析组的HOMA-IR、PGRN、IL-6、hs-CRP、血磷、甘油三酯、总胆固醇等指标治疗前后差异无统计学意义(P>0.05)。结论高通量透析能降低非糖尿病MHD患者血清PGRN水平,改善机体炎症状态及胰岛素抵抗。
Objective To investigate the effect of high-flux hemodialysis on serum progranulin and insulin resistance in non-diabetic patients with maintenance hemodialysis（MHD）. Methods A total of 60 non-diabetic patients with mainte- nance hemodialysis were randomly divided into high-flux hemodialysis group（n=30） and common dialysis group（n=30）. Another 20 healthy subjects matched for age and sex served as control group. Insulin resistance were assessed by home- ostasis model assessment of insulin resistance index（HOMA-IR）. Serum progranulin and interleukin-6（IL-6） before and after treatment of 6 months were determined by ELISA. High sensibility C-reactive protein （hs-CRP）, total serum calcium, serum phosphate（P）, parathroid hormone（PTH）, Serum triglyceride（TG）, total cholesterol,high density lipopro- tein cholesterol, low density lipoprotein cholesterol,and single pool KT/V（spKt/V） were also recorded. Result Corn- paired with the control group, HOMA-IR in high-flux hemodialysis group and common dialysis group was significantly higher at baseline. After treatment of six months, HOMA-IR,serum progranulin, IL-6, hs-CRP, P, TG, TC were signifi- cantly reduced in high-flux hemodialysis group（P〈0.05）, and lower than those in the common dialysis group（P〈0.05）. whereas the differences were no statistically significant changes of HOMA-IR, PGRN, IL-6, hs-CRP, P, TG, TC in common dialysis group （P〉0.05）. Conclusions High-flux dialysis could reduce serum level of progranulin, proinlamma- tory state and insulin resistance in non-diabetic patients with maintenance hemodialysis.
出处
《中国现代医生》
2017年第22期6-8,12,共4页
China Modern Doctor
基金
浙江省湖州市公益性技术应用研究(一般)(2014GY19)
