CAJ | 학술논문

目的观察移植肾功能恢复延迟(DGF)的受者应用持续低流量血液透析滤过(SLEDF)治疗的效果.方法术后发生DGF的肾移植受者33例,其中15例采用SLEDF法行肾脏替代治疗(SLEDF组),18例采用普通血液透析治疗(血透组).测定治疗前后两组肾功能,补体C3、C4,C反应蛋白(CRP),以及白细胞介素(IL)-1β、IL-6和肿瘤坏死因子α(TNF-α)的水平.结果 SLEDF组受者移植肾功能恢复时间为治疗后(29±13)d,血透组为治疗后(47±21)d.两组治疗后血肌酐和尿素氮水平均低于治疗前(P＜0.01)；两组治疗后IL-1β、IL-6和TNF-α水平低于治疗前,且治疗后SLEDF组低于血透组(P＜0.05)；治疗后两组补体和CRP水平有所降低,但与治疗前相比较,差异无统计学意义(P＞0.05).结论 SLEDF的杂合式肾脏替代治疗可有效降低受者体内血肌酐、尿素氮和部分细胞因子水平,有利于移植肾功能恢复,可作为DGF受者过渡期的肾脏替代治疗方法.
목적 관찰이식신공능회복연지(DGF)적수자응용지속저류량혈액투석려과(SLEDF)치료적효과.방법 술후발생DGF적신이식수자33례,기중15례채용SLEDF법행신장체대치료(SLEDF조),18례채용보통혈액투석치료(혈투조).측정치료전후량조신공능,보체C3、C4,C반응단백(CRP),이급백세포개소(IL)-1β、IL-6화종류배사인자α(TNF-α)적수평.결과 SLEDF조수자이식신공능회복시간위치료후(29±13)d,혈투조위치료후(47±21)d.량조치료후혈기항화뇨소담수평균저우치료전(P＜0.01)；량조치료후IL-1β、IL-6화TNF-α수평저우치료전,차치료후SLEDF조저우혈투조(P＜0.05)；치료후량조보체화CRP수평유소강저,단여치료전상비교,차이무통계학의의(P＞0.05).결론 SLEDF적잡합식신장체대치료가유효강저수자체내혈기항、뇨소담화부분세포인자수평,유리우이식신공능회복,가작위DGF수자과도기적신장체대치료방법.
Objective To observe the effect of hybrid renal replacement therapy (sustained lowefficiency hemodiafiltration) in recipients with delayed graft function (DGF) after kidney transplantation.Methods In 33 kidney transplant patients with DGF,there were 15 cases subject to sustained low-efficiency hemodiafiltration (SLEDF group),18 cases subject to hemodialysis (HD group).The renal function was tested,and the expression levels of complements C3,C4,and CRP,IL-1β,IL-6,TNF-α were detected before and after therapy.Results In SLEDF group,the renal function recovered in (29 ± 13) days after therapy,and in (47 ± 21) days in HD group.After therapy,the BUN and Scr in both two groups were lower than before (P＜0.01).After therapy,the levels of IL-1β,IL-6 and TNF-α were also lower than before in two groups,and the levels were lower in SLEDF group than in HD group (P＜0.05).The levels of complements C3,C4,and CRP in two groups were decreased after therapy,but there was no statistically significant difference (P＞0.05).Conclusion SLEDF can decrease the level of SCr,BUN and some cytokines in recipients effectively,and It's helpful to recovery of the renal function.SLEDF can be used by DGF recipients in transit time.