不同血液净化方式对维持性血液透析患者微炎症指标及Fetuin-A的相关性研究

发布时间：2018-11-19 19:32

【摘要】：目的：探讨高通量血液透析(HFHD)和血液透析滤过(OL-HDF)两种血液净化模式对尿毒症患者血清白介素-1β(IL-1β)、超敏C-反应蛋白(hs-CRP)、降钙素原(PCT)、钙(Ca)、磷(P)、胎球蛋白A(Fetuin-A)水平的影响,旨在探讨求其相关性。方法：按不同血液净化模式,将维持性血液透析(MHD)患者随机分为A组HFHD组30例,B组OL-HDF组30例,C组健康对照组16例,测定A组、B组透析前、透析6个月后血清IL-1β、hs-CRP、PCT、Ca、P、Fetuin-A值,测定C组晨起空腹血清IL-1β、hs-CRP、PCT、Ca、P、Fetuin-A值。结果：A、B组透析前血清IL-1β、hs-CRP、PCT、P指标均较C组明显升高(P0.05),Ca、Fetuin-A指标较C组明显降低(P0.05)。治疗六个月后,A、B组血清IL-1β、hs-CRP、P指标均明显降低,B组降低幅度大于A组(P0.05),A、B组血清Fetuin-A值明显升高,B组升高幅度大于A组(P0.05)。血清Fetuin-A与IL-1β、hs-CRP、P、Ca×P呈负相关关系。结论：维持性血液透析(MHD)患者存在微炎症状态,其钙化抑制因子Fetuin-A较正常人明显降低,本研究证明,血清Fetuin-A与IL-1β、hs-CRP、P、CaXP呈负相关关系,长期OL-HDF治疗(治疗大于6个月),对于改善MHD患者微炎症状态及升高钙化抑制因子Fetuin-A效果均明显优于HFHD。
[Abstract]:Objective: to investigate the effects of high-throughput hemodialysis (HFHD) and hemodiafiltration (OL-HDF) on serum interleukin-1 尾 (IL-1 尾), hypersensitive C-reactive protein (hs-CRP) and procalcitonin (PCT), in uremic patients. The effect of calcium, (Ca), phosphorus, (P), fetal globin A (Fetuin-A) level was studied. Methods: according to different blood purification models, the patients with maintenance hemodialysis (MHD) were randomly divided into A group (30 cases), B group (30 cases) and C group (16 cases). After 6 months of dialysis, the serum IL-1 尾 and hs-CRP,PCT,Ca,P,Fetuin-A levels were measured. The fasting serum IL-1 尾 and hs-CRP,PCT,Ca,P,Fetuin-A levels in group C were measured from morning to morning. Results: before dialysis, serum IL-1 尾 and hs-CRP,PCT,P in group A were significantly higher than those in group C (P0.05), and Ca,Fetuin-A were significantly lower than those in group C (P0.05). After six months of treatment, the serum IL-1 尾 and hs-CRP,P levels in group A were significantly lower than those in group A (P0.05). The serum Fetuin-A level in group A was significantly higher than that in group B (P0.05), and the increase in serum Fetuin-A in group B was higher than that in group A (P0.05). Serum Fetuin-A was negatively correlated with IL-1 尾 and hs-CRP,P,Ca 脳 P. Conclusion: there is a microinflammatory state in (MHD) patients with maintenance hemodialysis, and the calcification inhibitory factor (Fetuin-A) is significantly lower than that in normal controls. This study proves that serum Fetuin-A is negatively correlated with IL-1 尾 and hs-CRP,P,CaXP. Long-term OL-HDF therapy (more than 6 months) was more effective than HFHD. in improving microinflammation and increasing calcification inhibitory factor (Fetuin-A) in patients with MHD.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R692.5

【参考文献】