CAJ | 학술논문

目的：观察血液透析滤过对糖尿病维持性血液透析患者微炎性反应和胰岛素抵抗的影响。方法：选择糖尿病肾病血液透析患者56例，病情稳定，已排除急性感染及其他活动性疾病。随机分为常规血液透析组（27例）和血液透析滤过组（29例）。治疗6个月，分别观察两组患者治疗前后hsCRP、IL -6、甲状旁腺素（ PTH）和稳态模型胰岛素抵抗指数（ HOMA - IR）。结果：HOMA - IR 与hsCRP、IL -6相互之间呈正相关（P <0.05）。血液透析滤过组hsCRP、IL -6、PTH 和HOMA - IR 与治疗前相比，差异有统计学意义，而普通血液透析组治疗前后差异无统计学意义（ P >0.05）。结论：MHD 患者存在微炎性反应状态和胰岛素抵抗，血液透析滤过较低通量透析能明显改善糖尿病维持性血液透析患者微炎性反应状态和胰岛素抵抗。
목적：관찰혈액투석려과대당뇨병유지성혈액투석환자미염성반응화이도소저항적영향。방법：선택당뇨병신병혈액투석환자56례，병정은정，이배제급성감염급기타활동성질병。수궤분위상규혈액투석조（27례）화혈액투석려과조（29례）。치료6개월，분별관찰량조환자치료전후hsCRP、IL -6、갑상방선소（ PTH）화은태모형이도소저항지수（ HOMA - IR）。결과：HOMA - IR 여hsCRP、IL -6상호지간정정상관（P <0.05）。혈액투석려과조hsCRP、IL -6、PTH 화HOMA - IR 여치료전상비，차이유통계학의의，이보통혈액투석조치료전후차이무통계학의의（ P >0.05）。결론：MHD 환자존재미염성반응상태화이도소저항，혈액투석려과교저통량투석능명현개선당뇨병유지성혈액투석환자미염성반응상태화이도소저항。
Objective To study the effects of henodiafiltration on inflannation and insulin resistance in diabetic kidney disease pa-tients with naintenance henodialysis. Method Fifty-six diabetic patients with naintenance henodialysis were selected,who had underg-one henodialysis for nore than three nonths and were in a stable clinic status without signs of acute infections or other progressive disea-ses. These patients were divided into two groups:the HD group(treated with HD,n=27)and the HDF group(treated with HDF in addition to HD,n=29). Patients in each group were treated for 6 nonths. Serun IL-6,hsCRP and PTH were neasured at the start and end of the study. Insulin resistance was assessed by using the honeostasis nodel assessnent( HOMA-IR). Results In diabetic patients with nainte-nance henodialysis,after 6 nonth observation,the levels of HOMA-IR、IL-6 hsCRP and PTH in HDF group were significantly decreased according to HD group(P<0. 05). Conclusion This study denonstrates that HDF provides a better effect on inflannation and insulin re-sistance than does HD for diabetic patients naintained on henodialysis.