摘要
目的:探究血液透析(HD)联合血液灌流(HP)对尿毒症患者毒素清除率、炎性因子、钙磷代谢及免疫功能的影响。方法:选取尿毒症患者80例,以随机数字表法分为试验组和对照组各40例。对照组仅给予HD治疗,试验组给予HD联合HP治疗。于治疗前、治疗12周后采血,检测血清相关毒素含量,炎性因子、钙磷代谢及免疫功能指标水平。结果:两组治疗前血清相关毒素含量比较无统计学意义(P>0.05),治疗后血肌酐、血尿素氮、甲状旁腺素、β2-微球蛋白含量明显下降,而试验组较对照组下降更显著(P<0.05),且试验组血肌酐、血尿素氮、甲状旁腺素、β2-微球蛋白清除率明显高于对照组(P<0.05)。两组治疗前炎性因子、钙磷代谢及免疫功能指标水平比较无统计学意义(P>0.05),治疗后试验组血钙明显升高,血磷明显降低,血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)浓度明显降低,且显著优于对照组(P<0.05);治疗后所有患者血清IgA、IgG、IgM水平及补体C3、C4水平均明显较治疗前升高,但试验组IgA、IgM及补体C3、C4水平显著高于对照组(P<0.05)。结论:HD联合HP可有效提高尿毒症患者大、小分子毒素清除率,并对减轻炎症反应、维持钙磷代谢平衡、改善免疫功能有积极作用。
Objective:To explore the effect of hemodialysis(HD)combined with hemoperfusion(HP)on toxin clearance rate,inflammatory factors,calcium-phosphorus metabolism and immune function in patients with uremia.Methods:Eighty patients with uremia treated in the department of nephropathy of the hospital during the period were randomly divided into the experimental group and the control group with 40 cases in each group.The control group was only treated with HD,and the experimental group was treated with HD combined with HP.Blood was collected before treatment and after 12 weeks of treatment to detect levels of relevant serum toxins,inflammatory factors,calcium-phosphorus metabolism and immune function indexes.Results:There was no significant difference in levels of serum toxins between the two groups before treatment(P>0.05).After treatment,levels of serum creatinine,blood urea nitrogen,parathyroid hormone andβ2-microglobulin decreased significantly,and the decrease was more obvious in the experimental group than in the control group(P<0.05).There was no significant difference in levels of inflammatory factors,calcium-phosphorus metabolism or immune function indexes between the two groups before treatment(P>0.05).After treatment,serum calcium was significantly elevated,serum phosphorus,serum interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were significantly decreased in the experimental group.Besides,they were significantly better than those in the control group(P<0.05).After treatment,levels of serum IgA,IgG and IgM,complements C3 and C4 in both groups were significantly increased.However,the levels in the experimental group were significantly higher than those in the control group(P<0.05).Conclusion:HD combined with HP can effectively increase the clearance rate of large and small molecules of toxins in patients with uremia,and it has a positive effect on reducing inflammatory reactions,maintaining balance of calcium-phosphorus metabolism and improving immune function.
作者
陈昕
张莹
CHEN Xin;ZHANG Ying(Hanzhong Central Hospital,Department of Nephrology,Hanzhong 723000)
出处
《陕西医学杂志》
CAS
2019年第6期770-773,共4页
Shaanxi Medical Journal
基金
陕西省卫生和计划生育委员会科研项目(2016JM40132)
关键词
血液透析
血液灌流
尿毒症
炎性因子
钙磷代谢
免疫功能
Hemodialysis
Hemoperfusion
Uremia
Inflammatory factors
Calcium-phosphorus metabolism
Immune function
