血液灌流联合序贯透析对老年终末期糖尿病肾病患者炎症介质及氧化应激的影响

发布时间：2018-04-17 15:19

本文选题：血液灌流 + 序贯透析　；参考：《中国老年学杂志》2017年10期

【摘要】：目的研究血液灌流联合序贯透析对老年终末期糖尿病肾病(DN)患者炎症介质及氧化应激的影响。方法终末期DN患者92例根据治疗方法不同分为对照组和观察组。观察组每周2次常规血透同时接受每周1次血液灌流联合序贯透析治疗,对照组每周进行3次血液透析。评估两组患者血糖水平、肾功能、炎性介质水平及氧化应激状态。结果治疗后观察组患者C反应蛋白(CRP),肿瘤坏死因子(TNF)-α及白细胞介素(IL)-6水平均显著低于对照组(P0.05),丙二醛(MDA)、晚期蛋白氧化产物(AOPPs)水平均显著低于对照组(P0.05),超氧化物歧化酶(SOD)水平显著高于对照组(P0.05)。治疗后观察组患者总胆固醇(TC)、低密度脂蛋白(LDL)、甘油三酯(TG)、糖化血红蛋白(Hb A1c)和高密度脂蛋白(HDL)水平均显著低于对照组(P0.05);餐后2 h血糖、尿素氮(BUN)及尿蛋白水平均显著低于对照组(P0.05)。结论血液灌流联合序贯透析能够有效清除老年终末期DN患者炎症介质,缓解机体氧化应激状态,从而有助于控制血糖水平,改善肾功能,提高临床疗效。
[Abstract]:Objective to study the effects of hemoperfusion combined with sequential dialysis on inflammatory mediators and oxidative stress in elderly patients with end-stage diabetic nephropathy.Methods 92 patients with end-stage DN were divided into control group and observation group according to different treatment methods.The observation group was treated with hemoperfusion and sequential dialysis twice a week, while the control group was treated with hemodialysis three times a week.The levels of blood glucose, renal function, inflammatory mediators and oxidative stress were evaluated in both groups.Results after treatment, the levels of C-reactive protein (CRP), tumor necrosis factor TNF- 伪 (TNF- 伪) and interleukin-6 (IL-6) in the observation group were significantly lower than those in the control group (P 0.05), and the levels of malondialdehyde (MDA) MDAA, advanced protein oxidation product (AOPPs) were significantly lower than those in the control group (P 0.05), and the levels of superoxide disambiguation were significantly lower than those in the control group.The level of SOD was significantly higher than that of control group (P 0.05).After treatment, the levels of total cholesterol, low density lipoprotein (LDLN), triglyceride (TGN), HbA1c (glycosylated hemoglobin) and high density lipoprotein (HDL) in the observation group were significantly lower than those in the control group (P 0.05), and the blood glucose at 2 hours postprandial was significantly lower in the observation group than in the control group.The levels of urea nitrogen bun and urine protein were significantly lower than those of the control group (P 0.05).Conclusion Hemoperfusion combined with sequential dialysis can effectively remove inflammatory mediators and relieve oxidative stress in elderly patients with end-stage DN, which can help to control blood glucose level, improve renal function and improve clinical efficacy.
【作者单位】：贵州医科大学附属医院肾内科;
【基金】：贵州省科技计划项目(黔科合LG字【2012】047号)
【分类号】：R587.2;R692.9

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