论文部分内容阅读
探究尿毒症血液透析患者透析前后免疫指标及IL-6、CRP、IL-8、TNF-α的变化。抽取2013年4月至2015年10月我院78例尿毒症患者,随机数表法分组,各39例。实验组采用高通量血液透析(high-flux hemodialysis,HFHD),对照组采用低通量血液透析(low-flux hemodialysis,LFHD),两组均观察治疗6个月。对比治疗前后两组免疫指标CIgA、IgG、IgM及其C3、C4)、红细胞免疫指标[红细胞免疫复合花环(erythrocyte immune complex rosette,RBC-ICR)、红细胞免疫抑制率(erythrocyte immunosuppressive rate,RFIR)、红细胞C3b受体(erythrocyte C3breceptor,RBC-C3bR)、红细胞免疫促进因子(erythrocyte immune promoting factor,RFER)]、血清炎性因子(IL-6、IL-8、CRP、TNF-α)及营养状态指标(PA、ALB、Hb)水平变化情况。(1)免疫指标:治疗后两组IgA、IgG、IgM、C3、C4等指标水平均较治疗前增高,且实验组IgA、IgG、IgM、C3、C4水平高于对照组,差异有统计学意义(P<0.05);(2)红细胞免疫指标:治疗后实验组RBC-ICR、RFIR水平低于对照组,RBC-C3bR、RFER水平高于对照组,差异有统计学意义(P<0.05);(3)血清炎性因子:治疗后两组IL-6、IL-8、TNF-α、CRP等指标水平均较治疗前降低,且实验组各指标低于对照组,差异有统计学意义(P<0.05);(4)营养状态:治疗后两组各指标水平均较治疗前增高,且实验组PA、ALB、Hb水平高于对照组,差异有统计学意义(P<0.05)。采用血液透析治疗尿毒症患者可有效降低血清炎性因子水平,改善免疫功能及营养状态,且HFHD效果优于LFHD。
To investigate the changes of immune indexes and the levels of IL-6, CRP, IL-8 and TNF-α before and after dialysis in hemodialysis patients with uremia. 78 patients with uremia in our hospital from April 2013 to October 2015 were randomized into groups according to the random number table, with 39 cases in each group. High-flux hemodialysis (HFHD) was used in the experimental group and low-flux hemodialysis (LFHD) was used in the control group. Both groups were observed for 6 months. The immune indexes such as CIgA, IgG, IgM and C3, C4 were compared before and after treatment, erythrocyte immune parameters (erythrocyte immune complex rosette (RBC-ICR), erythrocyte immunosuppressive rate (RFIR) Erythrocyte C3breceptor (RBC-C3bR), erythrocyte immune promoting factor (RFER), serum inflammatory cytokines (IL-6, IL-8, CRP and TNF-α) (PA, ALB, Hb) level changes. (1) Immune index: After treatment, the levels of IgA, IgG, IgM, C3, C4 and other indexes in both groups were higher than those before treatment, and the levels of IgA, IgG, IgM, C3 and C4 in the experimental group were higher than those in the control group (P <0.05). (2) The index of erythrocyte immunity: The levels of RBC-ICR and RFIR in the experimental group were lower than those in the control group after treatment, the levels of RBC-C3bR and RFER were higher than those in the control group (3) Serum inflammatory factors: After treatment, the levels of IL-6, IL-8, TNF-α and CRP in the two groups were lower than those before treatment, and the indexes in the experimental group were lower than those in the control group (P <0.05). (4) Nutritional status: The levels of PA, ALB and Hb in experimental group were higher than those in control group after treatment, the difference was statistically significant (P <0.05). Hemodialysis treatment of uremic patients can effectively reduce serum levels of inflammatory cytokines, improve immune function and nutritional status, and HFHD better than LFHD.