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目的探讨血液灌流(HP)联合复方α酮酸(α-KA)对维持性血液透析(MHD)患者微炎症状态及营养状况的影响。方法 MHD患者90例随机均分为三组,分别接受单纯血液透析(HD)(A组)、HP联合HD(B组)或HP联合HD并加用α-KA口服(C组)治疗。治疗前及治疗6个月后,结合临床症状进行营养不良-炎症反应评分(MIS),测量体重指数(BMI),测定C反应蛋白(CRP)、血浆白蛋白(Alb)、总胆固醇(TC)、血清肌酐(SCr)、尿素氮(BUN)和血红蛋白(Hb),计算尿素清除率(Kt/V)。结果治疗6个月后,B和C组MIS评分分别为(5.28±1.49)分和(3.36±1.10)分,均明显低于A组的(10.90±3.15)分(P<0.01)。B、C组Alb和Hb也较A组有明显升高,CRP则明显下降(P<0.05)。结论 HP联合α-KA治疗可明显改善MHD患者的营养状况,减轻微炎症状态。
Objective To investigate the effects of hemoperfusion (HP) and compound α-ketoacid (α-KA) on the status of micro-inflammation and nutritional status in maintenance hemodialysis (MHD) patients. Methods Ninety patients with MHD were randomly divided into three groups and were treated with HD alone (group A), HP plus HD (group B) or HP plus HD plus α-KA orally (group C). Malnutrition - MIS, BMI, C - reactive protein (CRP), serum albumin (Alb) and total cholesterol (TC) were measured before treatment and 6 months after treatment. , Serum creatinine (SCr), blood urea nitrogen (BUN) and hemoglobin (Hb) were calculated and urea clearance (Kt / V) was calculated. Results After 6 months of treatment, the MIS scores of group B and C were (5.28 ± 1.49) points and (3.36 ± 1.10) points respectively, which were significantly lower than those of group A (10.90 ± 3.15) (P0.01). Alb and Hb in group B and group C were also significantly higher than those in group A, while CRP was significantly decreased (P <0.05). Conclusion HP combined with α-KA treatment can significantly improve the nutritional status of patients with MHD, reduce the status of micro-inflammation.