国际移植与血液净化杂志
國際移植與血液淨化雜誌
국제이식여혈액정화잡지
INTERNATIONAL JOURNAL OF TRANSPLANTATION AND HEMOPURIFICATION
2010年
1期
40-44
,共5页
马文录%许见丰%苗小梅%邢英英%张欲荣
馬文錄%許見豐%苗小梅%邢英英%張欲榮
마문록%허견봉%묘소매%형영영%장욕영
尿毒症%肾功能衰竭%透析%血液净化%细胞因子
尿毒癥%腎功能衰竭%透析%血液淨化%細胞因子
뇨독증%신공능쇠갈%투석%혈액정화%세포인자
Uremia%Renl failure%Dialysis%Hemodialysis%Cytokines
目的 研究不同血液净化方式对尿毒症透析患者血中细胞因子的清除效果.方法 将2006年4月至2009年2月在我院血液净化中心透析的45例患者按随机数字表法分为(1)血液透析联合血液灌流组;(2)血液透析滤过组;(3)HD组,血液透析组,每组15例.血液透析联合血液灌流组、血液透析滤过组每周治疗1次,每组患者治疗3次,中间间隔1周,第1次及第3次治疗前、后各从动脉端采血5 ml,并留取正常健康对照组血液,整批送检.测定治疗前、后血清细胞因子的浓度.结果 血液灌流联合血液透析组、血液透析滤过组及血液透析组治疗前、后白细胞介素1β、白细胞介素6、肿瘤坏死因子α浓度与健康对照组比较差异有统计学意义(P＜0.01);血液透析组患者血肿瘤坏死因子α、白细胞介素1β、白细胞介素6水平分别为(3±10)ng/L、(4±9)ng/L、(4±9)ng/L,治疗前、后差值比较分别为176.0%、141.0%、187.0%,血液透析滤过组血肿瘤坏死因子α、白细胞介素1β、白细胞介素6水平分别为(39±15)ng/L、(36±14)ng/L、(45±16)ng/L,治疗前后差值比较分别为24.6%、22.1%、29.8%,血液灌流联合血液透析组血肿瘤坏死因子α、白细胞介素1β、白细胞介素6水平分别为(48±16)ng/L、(38±15)ng/L、(50±14)ng/L,治疗前差值比较分别为27.8%、23.9%、32.3%,3组患者血肿瘤坏死因子α、白细胞介素1β、白细胞介素6水平间比较差异有统计学意义(t分别=17.39、11.24、21.89,P均＜0.01).结论 不同的血液净化方式对各类细胞因子的清除效果不同,其中液灌流联合血液透析组及血液透析滤过组治疗埘细胞因子清除有效,血液透析组治疗对细胞因子清除基本无效,液灌流联合血液透析组及血液透析滤过组细胞因子清除效果与血液透析滤过组比较差异无统计学意义(P＞0.05).
目的 研究不同血液淨化方式對尿毒癥透析患者血中細胞因子的清除效果.方法 將2006年4月至2009年2月在我院血液淨化中心透析的45例患者按隨機數字錶法分為(1)血液透析聯閤血液灌流組;(2)血液透析濾過組;(3)HD組,血液透析組,每組15例.血液透析聯閤血液灌流組、血液透析濾過組每週治療1次,每組患者治療3次,中間間隔1週,第1次及第3次治療前、後各從動脈耑採血5 ml,併留取正常健康對照組血液,整批送檢.測定治療前、後血清細胞因子的濃度.結果 血液灌流聯閤血液透析組、血液透析濾過組及血液透析組治療前、後白細胞介素1β、白細胞介素6、腫瘤壞死因子α濃度與健康對照組比較差異有統計學意義(P＜0.01);血液透析組患者血腫瘤壞死因子α、白細胞介素1β、白細胞介素6水平分彆為(3±10)ng/L、(4±9)ng/L、(4±9)ng/L,治療前、後差值比較分彆為176.0%、141.0%、187.0%,血液透析濾過組血腫瘤壞死因子α、白細胞介素1β、白細胞介素6水平分彆為(39±15)ng/L、(36±14)ng/L、(45±16)ng/L,治療前後差值比較分彆為24.6%、22.1%、29.8%,血液灌流聯閤血液透析組血腫瘤壞死因子α、白細胞介素1β、白細胞介素6水平分彆為(48±16)ng/L、(38±15)ng/L、(50±14)ng/L,治療前差值比較分彆為27.8%、23.9%、32.3%,3組患者血腫瘤壞死因子α、白細胞介素1β、白細胞介素6水平間比較差異有統計學意義(t分彆=17.39、11.24、21.89,P均＜0.01).結論 不同的血液淨化方式對各類細胞因子的清除效果不同,其中液灌流聯閤血液透析組及血液透析濾過組治療塒細胞因子清除有效,血液透析組治療對細胞因子清除基本無效,液灌流聯閤血液透析組及血液透析濾過組細胞因子清除效果與血液透析濾過組比較差異無統計學意義(P＞0.05).
목적 연구불동혈액정화방식대뇨독증투석환자혈중세포인자적청제효과.방법 장2006년4월지2009년2월재아원혈액정화중심투석적45례환자안수궤수자표법분위(1)혈액투석연합혈액관류조;(2)혈액투석려과조;(3)HD조,혈액투석조,매조15례.혈액투석연합혈액관류조、혈액투석려과조매주치료1차,매조환자치료3차,중간간격1주,제1차급제3차치료전、후각종동맥단채혈5 ml,병류취정상건강대조조혈액,정비송검.측정치료전、후혈청세포인자적농도.결과 혈액관류연합혈액투석조、혈액투석려과조급혈액투석조치료전、후백세포개소1β、백세포개소6、종류배사인자α농도여건강대조조비교차이유통계학의의(P＜0.01);혈액투석조환자혈종류배사인자α、백세포개소1β、백세포개소6수평분별위(3±10)ng/L、(4±9)ng/L、(4±9)ng/L,치료전、후차치비교분별위176.0%、141.0%、187.0%,혈액투석려과조혈종류배사인자α、백세포개소1β、백세포개소6수평분별위(39±15)ng/L、(36±14)ng/L、(45±16)ng/L,치료전후차치비교분별위24.6%、22.1%、29.8%,혈액관류연합혈액투석조혈종류배사인자α、백세포개소1β、백세포개소6수평분별위(48±16)ng/L、(38±15)ng/L、(50±14)ng/L,치료전차치비교분별위27.8%、23.9%、32.3%,3조환자혈종류배사인자α、백세포개소1β、백세포개소6수평간비교차이유통계학의의(t분별=17.39、11.24、21.89,P균＜0.01).결론 불동적혈액정화방식대각류세포인자적청제효과불동,기중액관류연합혈액투석조급혈액투석려과조치료시세포인자청제유효,혈액투석조치료대세포인자청제기본무효,액관류연합혈액투석조급혈액투석려과조세포인자청제효과여혈액투석려과조비교차이무통계학의의(P＞0.05).
Objectives To examine the effiency of various hemodialysis methods for uremic patients on removal of serum cytokines.Methods From April 2006 to February 2009,45 bemodialysis patients with chronic renal failure and uremia in the Hemodialysis Center,Third Affiliated HoSpital of Baotou Medical College,with pre-dialysis serum creatinine concentration ＞ 707 μmol/L,Ccr creatinine clearance ＜ 10 ml/min were randomly divided into three groups,each with 15 cases (1) hemoperfusion(HP) + hemedlalysis(HD)group,(2) bemodiafiltration(HDF) group and (3)HD group,HP+ HD group and HDF group received hemodialysis therapy once a week,three times per group with a week interval between treatments.5 ml arterial blood samples from each uremic patient and the normal control were collected respectively before and after the first and third hemodialysis and were submitted for the measurement of cytoldnes concentrations in serum.Results The concentration change of IL-1β,IL-6,serum TNF-α (tumor necrosis factor-α) between uremic patients and healthy controls was statistically significant (P＜0.01).The variation Of IL-1β and IL-6,TNF-α concentrations before and after treatment between HP+ HD group,HDF group and HD group as followed:in HDgroup TNF-α,IL-1β and IL-6 levels were ( 3±10) ng/L,(4±9) ng/L,( 4 ～ 9) ng/Land percentage change were 176.0%,141.0%,and 187.0%,respectively;in HDF group TNF-α,IL-1β and IL-6 levels were (39± 5)ng/L,(36±14)ng/L,(45±16)ng/L and percentage change were 24.6%,22.1% and 29.8%,respectively and in HP + HD group TNF-α,IL-1β and IL-6 levels were were (48±16)ng/L,(38±15)ng/L,(50±14)ng/L and percentage change were 27.8%,23.9% and 32.3%,respectively.Thus,in these three groups serum TNF-α,IL-1β and IL-6 levels were significantly changed between the treatments(t=17.39,11.24 and 21.89,respectively,P＜0.01).Conclusions This clinical study confirmed that efficacy of different treatments of hemodialysis to remove serum cytokines was various and HP + HD group and HDF group showed effective on cytokine removal while HD group didn' t.There was no significant difference between HP + HD and HDF on the serum cytokines removal in uremic patients.
