CAJ | 학술논문

目的：观察高通量透析与传统血液透析对透析患者微炎症和凝血的影响。方法选取40例接受高通量透析治疗患者作为研究组,并选择40例接受常规血液透析患者作为对照组。对两组患者治疗前和治疗6个月后的尿素氮( BUN)、甲状旁腺激素( PTH)改变,并比较两组患者的微炎症指标(血清C反应蛋白、白细胞介素-6、肿瘤坏死因子α)与凝血指标( aPTT、PA、PT、TT、Fbg )。结果①治疗前后两组 BUN水平差异不显著,但治疗后研究组 PTH含量(252.8±69.1)pg/L显著性低于对照组(294.2±72.4)pg/L,差异有统计学意义(P<0.05)；②两组患者治疗前血清C反应蛋白、白细胞介素-6及肿瘤坏死因子α含量接近,但治疗后研究组分别为(6.8±2.1) mg/L、(31.2±6.1) ng/L和(1.1±0.9)ug/L,均显著性低于对照组(20.4±8.7)mg/L、(47.1±8.7)ng/L和(12.2±1.9)ug/L,差异有统计学意义(P<0.05)；③治疗前两组凝血指标无显著差异(P>0.05),但研究组凝血时间长于对照组。30 min后血浆PT、aPTT、TT延长,而PA降低,Fbg呈上升趋势。对照组PT无明显改变,PA仅在30 min出现轻微下降,120 min后开始上升,120、240 min时PA值显著高于0 min(P<0.05),aPTT 30 min时延长,与0 min时比较差异显著(P<0.05),后逐渐恢复至原水平,TT与Fbg各时间段均保持递增趋势。结论与对传统血液透析相比,高通量透析可以有效清除患者血液中的大分子毒素以及微炎症因子,具有显著抗凝效果,临床效果优异。
목적：관찰고통량투석여전통혈액투석대투석환자미염증화응혈적영향。방법선취40례접수고통량투석치료환자작위연구조,병선택40례접수상규혈액투석환자작위대조조。대량조환자치료전화치료6개월후적뇨소담( BUN)、갑상방선격소( PTH)개변,병비교량조환자적미염증지표(혈청C반응단백、백세포개소-6、종류배사인자α)여응혈지표( aPTT、PA、PT、TT、Fbg )。결과①치료전후량조 BUN수평차이불현저,단치료후연구조 PTH함량(252.8±69.1)pg/L현저성저우대조조(294.2±72.4)pg/L,차이유통계학의의(P<0.05)；②량조환자치료전혈청C반응단백、백세포개소-6급종류배사인자α함량접근,단치료후연구조분별위(6.8±2.1) mg/L、(31.2±6.1) ng/L화(1.1±0.9)ug/L,균현저성저우대조조(20.4±8.7)mg/L、(47.1±8.7)ng/L화(12.2±1.9)ug/L,차이유통계학의의(P<0.05)；③치료전량조응혈지표무현저차이(P>0.05),단연구조응혈시간장우대조조。30 min후혈장PT、aPTT、TT연장,이PA강저,Fbg정상승추세。대조조PT무명현개변,PA부재30 min출현경미하강,120 min후개시상승,120、240 min시PA치현저고우0 min(P<0.05),aPTT 30 min시연장,여0 min시비교차이현저(P<0.05),후축점회복지원수평,TT여Fbg각시간단균보지체증추세。결론여대전통혈액투석상비,고통량투석가이유효청제환자혈액중적대분자독소이급미염증인자,구유현저항응효과,림상효과우이。
Objective To investigate the effects of high flux hemodialysis and conventional hemodialy-sis on micro inflammation and coagulation in dialysis patients. Methods 40 patients received high flux hemo-dialysis patients as research group,and select 40 patients undergoing regular hemodialysis as control group. Observe two groups of patients before treatment and after 6 months( predialysis) BUN,PTH change,and com-pare the two groups of patients with micro inflammatory markers(serum C reactive protein and interleukin-6, TNF-alpha ) , coagulation index records ( aPTT, PA, PT, TT, Fbg ) . Results the difference between the two groups before and after treatment of urea nitrogen levels was not significant,but the treatment group after the study parathyroid hormone level ( 252 . 8 ± 69 . 1 ) pg/L were significantly lower than those in control group (294.2 ±72.4)pg/L,the difference was statistically significant(P<0.05);in the two groups before treat-ment the serum C-reactive protein and interleukin-6 and tumor necrosis factor alpha content close to,but after treatment,study group were(6. 8 ± 2. 1) mg/L,(31. 2 ± 6. 1) ng/L and(1. 1 ± 0. 9) ug/L,were significantly lower than those of the control group(20. 4 ± 8. 7) mg/L,(47. 1 ± 8. 7) ng/L and(12. 2 ± 1. 9) ug/L. Differ-ence also had statistical significance(P<0. 05);the two groups had no significant difference in coagulation in-dexes before treatment(P> 0. 05),prolonged plasma PT,aPTT,TT of group 30 min,and PA decreased,Fbg increased. Control group PT had no obvious change,PA showed a slight drop in 30 min alone,120 min began to rise,120,240 min when the PA value was significantly higher than that of 0 min(P<0. 05),aPTT 30 min and 0 min were significantly prolonged,difference was significant(P<0. 05),then gradually restored to the o-riginal level,TT and Fbg each time all keep increasing trend. Conclusion Compared with the conventional hemodialysis,high flux hemodialysis can effectively remove big molecule toxins in the blood of a patient and micro inflammatory factor has significant anticoagulant effect,excellent clinical effect.