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目的观察血液透析与血液灌流联合治疗对终末期糖尿病肾病(ESDN)患者炎症介质及营养状态的影响。方法选取2014年1月至2016年8月永城市人民医院终末期糖尿病肾病患者65例,随机分为观察组(33例)及对照组(32例)。对照组行单纯血液透析治疗,观察组行血液透析与血液灌流联合治疗。检测对比两组治疗前后血清炎症介质[肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、C反应蛋白(CRP)]水平,并通过体质量指数(BMI)、血红蛋白(Hb)、血清白蛋白(Alb)评价患者营养状态。结果治疗前两组TNF-α、IL-6、CRP水平比较,差异无统计学意义(P>0.05),治疗后观察组TNF-α、IL-6、CRP水平明显低于对照组,差异具有统计学意义(P<0.05);治疗前两组BMI、Hb、Alb对比,差异无统计学意义(P>0.05),治疗后观察组BMI、Hb、Alb均高于对照组,差异有统计学意义(P<0.05)。结论 ESDN患者应用血液透析与血液灌流联合治疗,可明显降低炎症介质水平,改善营养状态。
Objective To observe the effects of hemodialysis and hemoperfusion on inflammatory mediators and nutritional status in patients with end stage diabetic nephropathy (ESDN). Methods From January 2014 to August 2016, 65 patients with end-stage diabetic nephropathy in Yongcheng People’s Hospital were randomly divided into observation group (33 cases) and control group (32 cases). The control group was treated with hemodialysis only. The observation group was treated with hemodialysis and hemoperfusion. The levels of serum inflammatory mediators [TNF-α, IL-6 and CRP] were measured and compared before and after treatment. The body mass index (BMI), hemoglobin Hb), serum albumin (Alb) evaluation of nutritional status of patients. Results There was no significant difference in TNF-α, IL-6 and CRP levels between the two groups before treatment (P> 0.05). After treatment, the levels of TNF-α, IL-6 and CRP in the observation group were significantly lower than those in the control group (P <0.05). There was no significant difference in BMI, Hb and Alb between the two groups before treatment (P> 0.05). After treatment, the BMI, Hb and Alb in the observation group were higher than those in the control group Significance (P <0.05). Conclusion ESDN patients combined hemodialysis and hemoperfusion can significantly reduce the level of inflammatory mediators and improve the nutritional status.