摘要
目的探讨高压氧辅助血液透析联合灌流治疗对终末期糖尿病肾病患者肾功能及免疫炎性因子的影响。方法选取连云港市第二人民医院肾内科2016年6月至2017年12月收治住院的92例终末期糖尿病肾病患者,按随机数字表法分为对照组和观察组各46例。对照组给予常规综合性治疗及血液透析联合灌流治疗,观察组在对照组基础上辅以高压氧治疗。比较2组患者治疗前后空腹血糖(FBG)、24 h尿蛋白(24 h Upro)、尿素氮(BUN)、肌酐(Cr)、尿酸及清蛋白(ALB)水平,以及免疫炎性因子白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、白细胞介素-17(IL-17)、单核细胞趋化蛋白-1(MCP-1)和超敏C反应蛋白(hs-CRP)含量。结果治疗后,2组患者FBG、肾功能相关指标及免疫炎性因子水平较治疗前均有明显改善(P<0.05);观察组Cr、24 h Upro及ALB分别为(482.54±166.46)μmol/L、(1 095.34±154.78)mg及(33.04±3.91)g/L,改善情况显著优于对照组(P<0.05),免疫炎性因子IL-6、IL-10、IL-17、MCP-1和hs-CRP改善情况均优于对照组(P<0.05),低血糖、低氧血症、低血压、感染及心脑血管事件等并发症发生率也明显低于对照组(P<0.05)。结论高压氧治疗通过降低终末期糖尿病肾病(DN)患者血清免疫炎性因子IL-6、IL-17、MCP-1和hs-CRP水平,增加IL-10含量,能有效抑制炎症刺激对血管内皮功能的损伤,修复肾脏微血管循环,从而改善肾功能。
Objective To explore the effects of hyperbaric oxygen-assisted hemoperfusion on renal function and immune inflammatory cytokines in patients with end-stage diabetic nephropathy(ESDN).Methods A total of 92 patients with ESDN admitted to the Department of Nephrology of the Second People’s Hospital of Lianyungang from June 2016 to December 2017 were randomly divided into control group(n=46)and observation group(n=46).The control group was given conventional treatment and the combination of hemodialysis with hemoperfusion,while the observation group was treated with hyperbaric oxygen on the basis of the treatments of the control group.The levels of fasting blood glucose(FBG),24-hour urinary protein(24 h Upro),blood urea nitrogen,creatinine(Cr),uric acid and albumin(ALB),and the contents of immune inflammatory cytokines such as interleukin-6(IL-6),interleukin-10(IL-10),interleukin-17(IL-17),monocyte chemoattractant protein-1(MCP-1),and hypersensitive C-reactive protein(hs-CRP)were compared between the two groups before and after treatment.Results After treatment,the levels of FBG,renal function indicators,and the contents of immune inflammatory cytokines in the two groups were significantly improved in comparison with those before treatment(P<0.05).The levels of Cr,24 h Upro,and ALB in the observation group were(482.54±166.46)μmol/L,(1095.34±154.78)mg,and(33.04±3.91)g/L,respectively,which were significantly better than those in the control group(P<0.05).The improvements in IL-6,IL-10,IL-17,MCP-1,and hs-CRP contents in the observation group were significantly better than those in the control group(P<0.05).The incidences of complications such as hypoglycemia,hypoxemia,hypotension,infection,and cardio-cerebrovascular events in the observation group were also significantly lower than those in the control group(P<0.05).Conclusion Hyperbaric oxygen-assisted hemoperfusion can effectively inhibit vascular endothelial injury due to inflammatory irritation and restore renal microvascular circulation to improve renal funct
作者
何传梅
刘锦秀
李慧
刘晓东
伏广浩
史文彬
徐同道
He Chuanmei;Liu Jinxiu;Li Hui;Liu Xiaodong;Fu Guanghao;Shi Wenbin;Xu Tongdao(Department of Nephrology,The Second People’s Hospital of Lianyungang,Lianyungang 222000,China)
出处
《中华航海医学与高气压医学杂志》
CAS
CSCD
2021年第4期460-463,共4页
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
关键词
高压氧
糖尿病肾病
肾功能
免疫炎性因子
Hyperbaric oxygen
Diabetic nephropathy
Renal function
Immune inflammatory cytokines
