摘要
目的:探讨高通量透析(HFD)与血液透析滤过(HDF)对慢性肾衰竭(CRF)患者IL-17、CD16表达影响。方法:收集2017年10月至2018年12月在本院进行治疗的CRF患者131例,采用HFD治疗的67例患者为HFD组,64例采用HDF治疗的患者为HDF组,另收集同期在我院体检的健康志愿者56例作为对照组,比较HFD组、HDF组治疗前后及对照组IL-17与CD16水平,并比较治疗后2组疗效和不良反应,利用受试者工作特征曲线(ROC)分析IL-17与CD16在CRF中的诊断价值,使用多因素Logistic回归分析患者并发高血压危险因素。结果:治疗前HFD组与HDF组的IL-17表达差异无统计学意义(P>0.05),HFD组与HDF组的IL-17水平显著高于对照组(P<0.05),治疗后HFD组与HDF组的IL-17均显著降低(P<0.05),且两组治疗后的IL-17均显著高于对照组(P<0.05),HFD组IL-17高于HDF组(P<0.05)。治疗前HFD组与HDF组的CD16比较差异无统计学意义(P>0.05),HFD组与HDF组的CD16水平显著低于对照组(P<0.05),治疗后HFD组与HDF组的CD16均治疗前显著升高(P<0.05),且两组治疗后的CD16均显著低于对照组(P<0.05),HFD组CD16低于HDF组(P<0.05)。ROC曲线显示IL-17曲线下面积为0.914,CD16曲线下面积为0.889,联合检测曲线下面积为0.964,HFD组与HDF组疗效比较差异无统计学意义(P>0.05),在心率失常和低血压上HFD组的发生率显著低于HDF组(P<0.05),多因素Logstic回归分析发现高水平血磷,IL-17,低水平CD16是CRF患者并发高血压的独立危险因素。结论:HFD与HDF均会降低患者的IL-17,提高CD16,且HDF改善程度更好,两种方式疗效无明显区别。HFD可以降低患者治疗后并发心律不齐以及低血压的概率,高水平血磷,IL-17,低水平CD16是CRF患者并发高血压的独立危险因素。
Objective:Effects of high flux dialysis(HFD)and hemodiafiltration(HDF)on expression of IL-17 and CD16 in patients with chronic renal failure(CRF).Methods:Collected 131 CRF patients treated in our hospital from October 2017 to December 2018,67 patients treated with high-throughput dialysis as the HFD group,64 patients undergoing hemodiafiltration treated patients were taken as HDF group,and 56 healthy people who had undergone physical examination in our hospital during the same period were collected as the control group.Levels of IL-17 and CD16 in HFD group,HDF group before and after treatment and control group were compared.Therapeutic efficacy and adverse reactions of the group were analyzed with receiver operating characteristic curve(ROC)to analyze the diagnostic value of IL-17 and CD16,and multivariate logistic regression was used to analyze risk factors of patients with hypertension.Results:There was no significant difference in IL-17 between the HFD group and the HDF group before treatment(P>0.05),the IL-17 level in the HFD group and the HDF group was significantly higher than that in control group P<0.05),after treatment IL-17 in HFD group and HDF group were significantly decreased(P<0.05),and IL-17 in both groups after treatment was significantly higher than that in control group(P<0.05),IL-17 in HFD group was higher than HDF group(P<0.05).Before treatment,there was no significant difference in CD16 between the HFD group and HDF group(P>0.05).CD16 level of the HFD group and the HDF group was significantly lower than that of the control group(P<0.05).CD16 of the two groups was significantly decreased and increased before treatment(P<0.05),and the CD16 of the two groups after treatment was significantly lower than that of control group(P<0.05),and CD16 of HFD group was lower than that of HDF group(P<0.05),ROC curve showed that area under curve of IL-17 was 0.914,area under curve of CD16 was 0.889,and area under combined test was 0.964.There was no difference in the efficacy of HFD group and HDF group(P>0.05
作者
徐明芝
安娜
陈汝满
白亚飞
贺纪清
XU Ming-Zhi;AN Na;CHEN Ru-Man;BAI Ya-Fei;HE Ji-Qing(Center for Blood Purification,Hainan Provincial People′s Hospital,Haikou 570311,China)
出处
《中国免疫学杂志》
CAS
CSCD
北大核心
2020年第13期1641-1646,共6页
Chinese Journal of Immunology
