不同血液透析方式对非糖尿病肾病透析患者胰岛素抵抗的影响

发布时间：2019-07-14 21:17

【摘要】：目的探讨不同血液透析方式对非糖尿病肾病患者胰岛素抵抗(IR)的影响。方法选取徐州市中心医院2014年1月至2015年1月收治的非糖尿病肾病透析患者101例,将其分为3组,分别采用高通量血液透析(HFHD)、低通量血液透析(LFHD)和血液透析滤过(HDF)。透析治疗6个月后,比较3组透析患者的临床资料及生化指标,并采用Pearson相关分析及Logistic回归分析对稳态模型胰岛素抵抗指数(HOMA-IR))的相关因素进行分析。结果HDF组和HFHD组的甲状旁腺素(PTH)水平明显低于LFHD组,而尿素清除指数(Kt/V)明显高于LFHD组(P0.05);HDF组β2-微球蛋白(β2-MG)、空腹胰岛素(FINS)水平及HOMR-IR明显低于HFHD组和LFHD组(P0.05),且HDF组β2-MG清除率(β2-MGCR)明显高于HFHD组和LFHD组(P0.001)。Pearson相关分析表明,HOMA-IR与体质量指数(BMI)呈正相关(r=0.346,P=0.014),与β2-MGCR及高密度脂蛋白胆固醇(HDL-C)呈负相关(r=-0.412,P=0.002;r=-0.204,P=0.042)。Logistic回归性分析表明,BMI(OR=1.538,95%CI:1.364~1.759,P=0.021)和HDF(OR=0.137,95%CI:0.045~0.632,P=0.012)为影响HOMA-IR的独立因素。结论相较于HFHD和LFHD,HDF可以改善非糖尿病肾病透析患者的IR状态,对临床治疗具有重要意义。
[Abstract]:Objective to investigate the effect of different dialysis methods on insulin resistance (IR) in patients with non-diabetic nephropathy. Methods 101 patients with non-diabetic nephropathy treated in Xuzhou Central Hospital from January 2014 to January 2015 were divided into three groups. (LFHD) and (HDF). Were treated with high throughput (HFHD), and hemodiafiltration, respectively. After 6 months of dialysis treatment, the clinical data and biochemical indexes of the three groups were compared, and the related factors of insulin resistance index (HOMA-IR) in steady state model were analyzed by Pearson correlation analysis and Logistic regression analysis. Results the level of parathyroxine (PTH) in HDF group and HFHD group was significantly lower than that in LFHD group, while the urea clearance index (Kt/V) was significantly higher than that in LFHD group (P 0.05). The fasting insulin (FINS) and HOMR-IR levels of 尾 2-microglobulin (尾 2-MG),) in HDF group were significantly lower than those in HFHD group and LFHD group (P 0.05), and the clearance rate of 尾 2-MG in HDF group (尾 2-MGCR) was significantly higher than that in HFHD group and LFHD group (P0.001). Pearson correlation analysis showed that HOMA-IR was positively correlated with body mass index (BMI) (r 鈮，

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