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目的分析血液透析及腹膜透析对非糖尿病终末期肾病患者胰岛素抵抗、微炎症状态及脂质代谢的影响。方法将福田医院2012年8月至2014年5月间收治的94例非糖尿病终末期肾病新入透析患者作为研究对象进行前瞻性研究,分成血液透析组(n=48)及腹膜透析组(n=46),观察12个月,比较两种不同透析方式对胰岛素抵抗、微炎症状态及脂质代谢的影响。结果治疗12个月后,腹膜透析组患者的胰岛素抵抗指数、总胆固醇、三酰甘油、低密度脂蛋白水平均高于血液透析组,组间比较差异有统计学意义。炎症因子超敏C-反应蛋白水平、空腹血糖、空腹胰岛素、糖化血红蛋白、高密度脂蛋白组间比较差异未见统计学意义。结论腹膜透析可能较血液透析加重非糖尿病终末期肾病患者的胰岛素抵抗状态及脂质代谢紊乱,治疗期间需关注并纠正代谢紊乱,预防相关并发症的发生。
Objective To analyze the effect of hemodialysis and peritoneal dialysis on insulin resistance, microinflammatory state and lipid metabolism in non-diabetic patients with end-stage renal disease. Methods A total of 94 patients with non-diabetic end-stage renal disease admitted to Futian Hospital from August 2012 to May 2014 were prospectively divided into hemodialysis group (n = 48) and peritoneal dialysis group (n = 46) for 12 months, comparing the effects of two different dialysis modalities on insulin resistance, microinflammatory state and lipid metabolism. Results After 12 months of treatment, the insulin resistance index, total cholesterol, triglyceride, and low density lipoprotein in peritoneal dialysis group were higher than those in hemodialysis group. There was significant difference between the two groups. Inflammatory factor C-reactive protein, fasting plasma glucose, fasting insulin, glycosylated hemoglobin, high-density lipoprotein were no significant difference between groups. Conclusion Peritoneal dialysis may aggravate the insulin resistance status and lipid metabolism disorder in patients with non-diabetic end-stage renal disease than hemodialysis. During the treatment, metabolic disorder should be concerned and corrected to prevent the related complications.