血液透析滤过对血透患者红细胞免疫粘附功能及氧亲和力的影响

发布时间：2018-06-05 19:16

本文选题：血液透析滤过 + 维持性血液透析　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的:本研究旨在探讨血液透析滤过(HDF)对维持性血液透析(MHD)患者红细胞免疫粘附功能及氧亲和力的影响。方法:1.选取2016年10月至2016年12月在广西医科大学第一附属医院血液净化中心治疗的MHD患者28例为病例组,同期健康体检者20例为健康对照组。2.MHD患者均接受4小时HDF治疗1次,治疗参数如下:均采用前稀释置换法、碳酸氢盐透析液透析,血流量250-300ml/min,透析液流量500ml/min,置换液流量125-150ml/min。3.采用红细胞花环试验检测红细胞免疫粘附功能的指标,即红细胞C3b受体花环率(E-C3bRR)与红细胞免疫复合物花环率(E-ICRR);采用酶联免疫吸附试验(ELisa)检测血红蛋白氧亲和力的指标,即红细胞2,3-二磷酸甘油酸(2,3-DPG);同时检测血肌酐、尿素氮、β2-微球蛋白(β2-MG)、二氧化碳结合力、血磷、血钾等生化指标。4.检测MHD患者HDF治疗前、后E-C3bRR、E-ICRR、红细胞2,3-DPG及血生化指标。检测健康体检者E-C3bRR、E-ICRR。5.比较MHD患者HDF治疗前、后E-C3bRR、E-ICRR、红细胞2,3-DPG及血生化指标的差异;比较MHD患者HDF治疗前、后E-C3bRR、E-ICRR与健康对照组间的差异。结果:1.MHD患者HDF治疗前、后E-C3bRR、E-ICRR均较健康对照组降低(P0.05);2.MHD患者HDF治疗后E-C3bRR较HDF治疗前升高(P0.05);3.MHD患者HDF治疗前、后E-ICRR及红细胞2,3-DPG无变化(P0.05);4.与HDF治疗前相比,MHD患者HDF治疗后二氧化碳结合力升高(P0.001),血肌酐、尿素氮、β2-MG、血磷均降低(P0.001)。结论:MHD患者红细胞免疫粘附功能下降,识别、粘附、清除循环免疫复合物能力降低,单次HDF治疗能提高MHD患者红细胞免疫粘附活性,但不改变红细胞血红蛋白氧亲和力。
[Abstract]:Objective: to investigate the effect of hemodiafiltration (HDF) on erythrocyte immune adherence and oxygen affinity in patients with maintenance hemodialysis (MHD). Method 1: 1. From October 2016 to December 2016, 28 MHD patients treated in the blood purification center of the first affiliated Hospital of Guangxi Medical University were selected as the case group, and 20 healthy persons as the healthy control group. The parameters were as follows: predilute replacement, bicarbonate dialysate dialysis, blood flow 250-300ml / min, dialysate 500ml / min, replacement fluid 125-150ml / min.3. Erythrocyte rosette test was used to detect erythrocyte immune adherence function, namely erythrocyte C3b receptor rosette rate (E-C3bRR) and erythrocyte immune complex rosette rate (E-ICRRR), and enzyme linked immunosorbent assay (Elisa) to detect hemoglobin oxygen affinity. The biochemical indexes of blood creatinine, urea nitrogen, 尾 2-microglobulin (尾 2-MGG), carbon dioxide binding capacity, blood phosphorus and blood potassium were determined. Before and after HDF treatment, the levels of E-C3bRRRN E-ICRRRR, erythrocyte 23-DPG and blood biochemical indexes were measured in MHD patients. E-C3bRRN E-ICRR.5. Before and after HDF treatment, the differences of E-ICRRR, erythrocyte 23-DPG and blood biochemical indexes in MHD patients were compared, and the differences between E-C3bRRRrr-E-ICRR and healthy controls before and after HDF treatment in MHD patients were compared. Results 1. Before and after HDF treatment, E-C3bRRRN E-ICRR in MHD patients was significantly lower than that in healthy controls. 2. After HDF treatment, E-C3bRR in MHD patients was higher than that in HDF patients before HDF treatment, but there was no change in E-ICRR and erythrocyte 23-DPG in MHD patients before and after HDF treatment. Compared with those before HDF treatment, the carbon dioxide binding capacity of MHD patients increased P0.001C, serum creatinine, urea nitrogen, 尾 2-MGand blood phosphorus decreased P0.001g. Conclusion the erythrocyte immune adherence function of MHD patients was decreased, and the ability to recognize, adhere and clear the circulating immune complex was decreased. Single HDF therapy could improve erythrocyte immune adherence activity, but did not change the oxygen affinity of erythrocyte hemoglobin in MHD patients.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R692.5

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