探讨尿毒症血液透析患者透析前后免疫指标及IL-6、CRP、IL-8、TNF-α的变化

发布时间：2018-02-01 02:37

本文关键词： 尿毒症血液透析免疫指标血清炎性因子　出处：《现代免疫学》2017年06期 　论文类型：期刊论文

【摘要】：探究尿毒症血液透析患者透析前后免疫指标及IL-6、CRP、IL-8、TNF-α的变化。抽取2013年4月至2015年10月我院78例尿毒症患者,随机数表法分组,各39例。实验组采用高通量血液透析(high-flux hemodialysis,HFHD),对照组采用低通量血液透析(low-flux hemodialysis,LFHD),两组均观察治疗6个月。对比治疗前后两组免疫指标CIgA、IgG、IgM及其C3、C4)、红细胞免疫指标[红细胞免疫复合花环(erythrocyte immune complex rosette,RBC-ICR)、红细胞免疫抑制率(erythrocyte immunosuppressive rate,RFIR)、红细胞C3b受体(erythrocyte C3breceptor,RBC-C3bR)、红细胞免疫促进因子(erythrocyte immune promoting factor,RFER)]、血清炎性因子(IL-6、IL-8、CRP、TNF-α)及营养状态指标(PA、ALB、Hb)水平变化情况。(1)免疫指标:治疗后两组IgA、IgG、IgM、C3、C4等指标水平均较治疗前增高,且实验组IgA、IgG、IgM、C3、C4水平高于对照组,差异有统计学意义(P0.05);(2)红细胞免疫指标:治疗后实验组RBC-ICR、RFIR水平低于对照组,RBC-C3bR、RFER水平高于对照组,差异有统计学意义(P0.05);(3)血清炎性因子:治疗后两组IL-6、IL-8、TNF-α、CRP等指标水平均较治疗前降低,且实验组各指标低于对照组,差异有统计学意义(P0.05);(4)营养状态:治疗后两组各指标水平均较治疗前增高,且实验组PA、ALB、Hb水平高于对照组,差异有统计学意义(P0.05)。采用血液透析治疗尿毒症患者可有效降低血清炎性因子水平,改善免疫功能及营养状态,且HFHD效果优于LFHD。
[Abstract]:Objective: to investigate the immune index and IL-6 CRP IL-8 in patients with uremia before and after hemodialysis. The changes of TNF- 伪. From April 2013 to October 2015, 78 patients with uremia in our hospital were randomly divided into two groups. The experimental group was treated with high-flux hemodialysis high-flux hemodialysis (HFHD). The control group was treated with low-flux hemodialysis and low-flux hemodialysis for 6 months. The immune index CIgA was compared before and after treatment. IgGN IgM and its C _ 3C _ 4C _ (4), erythrocyte immune Indexes. [Erythrocyte immune complex rosette (RBC-ICR). Erythrocyte immunosuppressive rate and erythrocyte immunosuppressive rateir). Erythrocyte C3b receptor RBC-C3bR. Erythrocyte immune promoting factor (RFER) and serum inflammatory factor IL-6 (IL-8). The changes of the level of CRPnTNF- 伪 and the nutritional status index (PAA) ALB (Hb): after treatment, the two groups were immunized with IgA, IgG, IgM, C 3. The level of C4 was higher than that before treatment, and the level of IgAg C _ 3C _ 3C _ 4 in the experimental group was higher than that in the control group (P < 0.05). (2) erythrocyte immune index: the RFIR level of RBC-ICRN in the experimental group was lower than that in the control group after treatment, and the level of rfer was higher than that in the control group. The difference was statistically significant (P 0.05). 3) Serum inflammatory factors: after treatment, the levels of IL-6, IL-8, TNF- 伪 and CRP in the two groups were lower than those before treatment, and the indexes in the experimental group were lower than those in the control group. The difference was statistically significant (P 0.05). (4) nutritional status: after treatment, the level of each index in the two groups was higher than that before treatment, and the level of PABBU HB in the experimental group was higher than that in the control group. The difference was statistically significant (P 0.05). Hemodialysis could effectively reduce the level of serum inflammatory factors, improve the immune function and nutritional status, and the effect of HFHD was better than that of LFHD.
【作者单位】：河北医科大学第一医院肾内科;
【基金】：河北省卫生厅医学科学研究课题(20120298)
【分类号】：R692.5
【正文快照】： 现代医学认为尿毒症为患者丧失肾功能后,机体生化过程紊乱而出现的一系列复杂综合征,其本质是机体无法经肾脏产生尿液,进而将机体中代谢废物与过多水分排出体外,从而引发毒害[1-2]。血液透析(hemodialysis,HD)为临床救治尿毒症患者的主要措施,可取得一定疗效,但尿毒症持续HD患

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