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目的探讨低通量血液透析(LFHD)与高通量血液透析(HFHD)对维持性血液透析(MHD)患者微炎症状态的影响。方法选择2011年5月至2012年11月在新疆维吾尔自治区人民医院血液净化中心行MHD治疗的慢性肾脏病(CKD)5期患者共40例,随机分为LFHD组和HFHD组各20例,观察两组患者首次透析前和透析治疗3个月后的白细胞介素-6(IL-6)、血清C反应蛋白(CRP)、血清β2-微球蛋白(β2-MG)的变化并进行分析比较。结果 LFHD组与HFHD组首次透前各项指标比较无统计学差异(P>0.05);LFHD组治疗前后比较对β2-MG、IL-6、CRP清除无统计学差异(P>0.05);HFHD组治疗3个月后对β2-MG、IL-6、CRP清除均下降,与治疗前比较有统计学差异(P<0.05);LFHD组与HFHD组之间治疗3个月后比较,HFHD组中β2-MG、IL-6、CRP下降明显,差异有统计学意义(P<0.05)。结论 HFHD较LFHD更能够有效清除中分子毒素和微炎症细胞因子,从而显著改善MHD患者的微炎症状态。
Objective To investigate the effects of low-flux hemodialysis (LFHD) and high-flux hemodialysis (HFHD) on the micro-inflammatory status in maintenance hemodialysis (MHD) patients. Methods Forty patients with chronic kidney disease (CKD) from May 2011 to November 2012 in MHD Center of Blood Purification Center of People’s Hospital of Xinjiang Uygur Autonomous Region were enrolled and randomly divided into two groups: LFHD group and HFHD group, 20 cases each. The levels of IL-6, CRP and β2-MG before the first dialysis and three months after dialysis in both groups were analyzed and compared . Results There was no significant difference between the LFHD group and the HFHD group (P> 0.05). The LFHD group had no significant difference in the clearance of β2-MG, IL-6 and CRP before and after treatment (P> 0.05) The levels of β2-MG, IL-6 and CRP in the HFHD group were significantly lower than those in the HFHD group (P <0.05) after 3 months of treatment. Β2-MG, IL-6, CRP decreased significantly, the difference was statistically significant (P <0.05). Conclusion HFHD is more effective than LFHD in removing cytokines and microinflammatory cytokines, which can significantly improve the micro-inflammatory status of MHD patients.