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目的探讨血液灌流(HP)频率与糖尿病终末期肾病(ESRD)微炎症状态的相关性。方法选取行常规血液透析(HD)治疗的糖尿病ESRD患者98例,按照随机数字表法分为对照组以及观察组A、B、C。对照组:常规HD治疗,每周3次,每次4 h。观察组A:在对照组基础上联合一周1次HP;观察组B:在对照组基础上联合每2周1次HP;观察组C:在对照组基础上联合每4周1次HP。4组患者分别于治疗前、治疗24周后检测炎症因子[肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、超敏C-反应蛋白(hs-CRP)]及肾功能[血肌酐(SCr)、尿素氮(BUN)],凝血功能[全血黏度(WBV)、血浆黏度(PV)、凝血酶时间(TT)]指标,记录治疗后各组患者的不良反应发生情况。结果治疗后各观察组微炎症、肾功能、凝血功能指标均较对照组有所改善(P<0.05),观察组A微炎症,肾功能指标水平,凝血功能指标中WBV、PV水平均低于观察组B、C,TT较观察组B、C更长(P<0.05)。各组患者治疗后恶心呕吐、发热、痉挛等不良反应发生率无统计学差异(P>0.05)。结论 HP与HD联合应用可较好地改善糖尿病ESRD患者的微炎症状态、肾功能及凝血功能,HD联合一周1次HP的疗效最佳。
Objective To investigate the correlation between the hemoperfusion (HP) frequency and microinflammatory state in diabetic end-stage renal disease (ESRD). Methods Ninety patients with diabetic ESRD treated with routine hemodialysis (HD) were divided into control group and observation group A, B and C according to random number table. Control group: conventional HD treatment, 3 times a week for 4 h each. Observation group A: once a week on the basis of the control group HP; observation group B: on the basis of the control group once every 2 weeks HP; observation group C: on the basis of the control group once every 4 weeks HP. Four groups of patients were tested for inflammatory cytokines (TNF-α, IL-6, hs-CRP) and renal (SCr, BUN), coagulation (whole blood viscosity (WBV), plasma viscosity (PV) and thrombin time (TT)] were measured and the adverse reactions of each group were recorded Happening. Results After treatment, the micro-inflammation, renal function and coagulation indexes in each observation group were improved compared with those in the control group (P <0.05). In the observation group, the levels of micro-inflammation, renal function indexes and coagulation indexes were lower than those in the observation group The observation group B, C, TT than the observation group B, C longer (P <0.05). Nausea, vomiting, fever, spasms and other adverse reactions in each group of patients after treatment there was no statistically significant difference (P> 0.05). Conclusion The combination of HP and HD can improve the micro-inflammatory state, renal function and coagulation function of diabetic patients with ESRD. HD combined with HP once a week has the best curative effect.