高通量血液透析对老年维持性血液透析患者的微炎症状态影响.docVIP

精品论文 参考文献 高通量血液透析对老年维持性血液透析患者的微炎症状态影响 李 静 　　天津市第一中心医院移植血透室 天津 300192 　　【摘 要】 目的：对老年维持性血液透析患者进行高通量血液透析治疗的微炎症状态影响情况进行统计研究。方法：将60例患者随机双盲分为两组，观察组30例与对照组30例，观察组患者应用高通量透析器，对照组患者应用低通量透析器，分别检测两组患者治疗前后血清样品中hs-CRP、IL-6、TNF-alpha;、Hcy、MDA、Alb、Tf、Hb、iPTH水平。结果：较治疗前观察组的患者治疗后3个月的各项指标均显著降低（P＜0.05），而对照组的患者的各指标治疗前后比较无显著性差异（P＞0.05）。hs-CRP与IL-6、TNF-alpha;、Hcy、MDA、iPTH呈现正相关性（P＜0.05），而与Alb、Tf等指标呈现负相关性（P＜0.05），与患者的Hb指标不具有相关性（P＞0.05）。结论：高通量透析对老年维持性血液透析患者的微炎症状有明显改善作用，值得临床上广泛推广。 　　【关键词】高通量血液透析；维持性血液透析；微炎症 　　【中图分类号】R453 【文献标识码】B 【文章编号】1674-8999（2015）8-0152-02 　　The influence of high flux hemodialysis on micro inflammatory state in elderly maintenance hemodialysis patients 　　【Abstract】 Objective：To analyze the influence of high flux hemodialysis on micro inflammatory state in elderly maintenance hemodialysis patients. Methods：60 cases were randomly divided into control group and observation group (30 cases in each group). Control group received low flux dialyzer; observation group received high flux dialyzer. hs-CRP, IL-6, TNF-alpha;, Hcy, MDA, Alb, Tf, Hb, IPTH levels in serum sample were compared before and after treatment. Results：All the indexes decreased significantly in observation group. There were no significant difference in control group. There were positive correlations between hs-CRP and IL-6, TNF-alpha;, Hcy, MDA, iPTH. There were negative correlations between hs-CRP and Alb, Tf. Conclusion：High flux dialysis had a significant effect on improving the micro inflammatory symptoms in elderly maintenance hemodialysis patients, was worthy of clinical application. 　　【Key words】High flux dialysis; Maintenance hemodialysis; Micro inflammatory 　　尿毒症主要临床表现为水电解质紊乱、水肿、呕吐、尿量少等，主要的治疗方案为通过血液透析清除患者血液中毒性物质[1]。血液透析（hemodialysis，HD）通过透析装置将体内血液有毒物质引流至体外的方法，血流经过无数根空心纤维组成的透析器中，血液与透析液进行物质交换，从而清除体内的代谢废物，可以维持电解质和酸碱平衡，同时也可以清除体内过多的水分[2]。通量指的是透析器对水的清除能力，用超滤系数Kuf(ml/mmHg/h)表示，根据透析器Kuf值不同分为低通量、中通量与高通量透析器。维持性血液透析治疗指利用血液透析延长尿毒症患者生命的过度方法。目前进行维持行血液透析的患者不仅包括慢性肾炎引起尿毒症，还包括糖尿病、高血压而导致的尿毒症。血液透析为常见的肾脏替代疗法，虽然能