CAJ | 학술논문

目的：观察血液透析滤过对糖尿病维持性血液透析(MHD)患者微炎症和胰岛素抵抗的影响。方法选择MHD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与治疗前相比显著下降，差异均有统计学意义(P<0.05)，而普通血液透析组治疗前后差异无统计学意义。结论 MHD患者存在微炎症状态和胰岛素抵抗，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症状态和胰岛素抵抗。
목적：관찰혈액투석려과대당뇨병유지성혈액투석(MHD)환자미염증화이도소저항적영향。방법선택MHD환자56례，병정은정，이배제급성감염급기타활동성질병。수궤분위상규혈액투석조(27례)화혈액투석려과조(29례)。치료6개월，분별관찰량조환자치료전후hsCRP、IL-6、갑상방선소(PTH)화은태모형이도소저항지수(HOMA-IR)。결과 HOMA-IR여hsCRP、IL-6상호지간정정상관(P<0.05)。혈액투석려과조hsCRP、IL-6、PTH화HOMA-IR여치료전상비현저하강，차이균유통계학의의(P<0.05)，이보통혈액투석조치료전후차이무통계학의의。결론 MHD환자존재미염증상태화이도소저항，혈액투석려과교저통량투석능명현개선당뇨병유지성혈액투석환자미염증상태화이도소저항。
Objective To study the effects of hemodiafiltration on inflammation and insulin resistance in pa-tients with diabetic kidney disease. Methods Fifty-six diabetic patients underwent hemodialysis for more than six months were selected, who were in a stable clinic status without signs of acute infections or other progressive diseases. These patients were divided into two groups:the HD group (treated with HD, n=27) and the HDF group (treated with HDF weekly in addition to HD, n=29). Patients in each group were treated for 6 months. Serum IL-6, hsCRP and PTH were measured at the start and end of the study. Insulin resistance was assessed by using homeostasis model assessment (HOMA-IR). Results In diabetic patients with maintenance hemodialysis, after 6-month observation, the levels of HOMA-IR, IL-6, hsCRP and PTH were significantly decreased compared to those before treatment in HDF group (P<0.05). However, there was no significant difference in HD group before and after treatment. Conclusion This study demonstrates that HDF provides a better effect on inflammation and insulin resistance than HD does for diabetic pa-tients maintained on hemodialysis.