[1]李会宁,黄智敏.高通量血液透析对老年终末期肾病患者氧化应激及微炎症状态的影响[J].新乡医学院学报,2023,40(11):1069-1073.[doi:10.7683/xxyxyxb.2023.11.012]
　LI Huining,HUANG Zhimin.Effect of high-flux hemodialysis on oxidative stress and microinflammatory status in elderly patients with end-stage renal disease[J].Journal of Xinxiang Medical University,2023,40(11):1069-1073.[doi:10.7683/xxyxyxb.2023.11.012]
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高通量血液透析对老年终末期肾病患者氧化应激及微炎症状态的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
40卷
期数:
2023年11
页码:
1069-1073
栏目:
临床研究
出版日期:
2023-11-05

文章信息/Info

Title:
Effect of high-flux hemodialysis on oxidative stress and microinflammatory status in elderly patients with end-stage renal disease
作者:
李会宁; 黄智敏
（宁德师范学院附属宁德市医院肾内科，福建　宁德　352000）
Author(s):
LI Huining; HUANG Zhimin
(Department of Nephrology,Ningde Municipal Hospital of Ningde Normal University,Ningde 352000,Fujian Province,China)
关键词:
终末期肾病; 高通量血液透析; 氧化应激; 微炎症状态
Keywords:
end-stage renal disease; high-flux hemodialysis; oxidative stress; microinflammatory
分类号:
R459.5
DOI:
10.7683/xxyxyxb.2023.11.012
文献标志码:
A
摘要:
目的　探讨高通量血液透析（HFHD）对老年终末期肾病患者氧化应激及微炎症状态的影响。
方法　选择2020年6月至2022年6月于宁德师范学院附属宁德市医院接受血液透析（HD）治疗的80例老年终末期肾病患者为研究对象，根据治疗方法将患者分为HD组和HFHD组，每组40例。分别于透析前及透析6个月后，使用可见分光光度计检测血清丙二醛（MDA）、髓过氧化物酶（MPO）及超氧化物歧化酶（SOD）水平，酶联免疫吸附试验检测血清C反应蛋白（CRP）、白细胞介素-6（IL-6）及肿瘤坏死因子-α（TNF-α）水平，全自动生物化学分析仪检测血清肌酐（Scr）和血尿素氮（BUN）水平。记录2组患者HD期间并发症的发生情况。
结果　透析前，2组患者的血清 MDA、MPO及SOD水平比较差异无统计学意义（P>0.05）；透析6个月后，HFHD组患者的血清MDA、MPO水平显著低于HD组，血清SOD水平显著高于HD组（P<0.05）；2组患者透析6个月后的血清MDA、MPO水平显著高于透析前，血清SOD水平显著低于透析前（P<0.05）。透析前，2组患者的血清CRP、IL-6及TNF-α水平比较差异无统计学意义（P>0.05）；透析6个月后，HFHD组患者的血清CRP、IL-6及TNF-α水平显著低于HD组（P<0.05）；2组患者透析6个月后的血清CRP、IL-6及TNF-α水平显著高于透析前（P<0.05）。透析前，2组患者的Scr、BUN水平比较差异无统计学意义（P>0.05）；透析6个月后，HFHD组患者的Scr、BUN水平显著低于HD组（P<0.05）；2组患者透析6个月后的Scr、BUN水平显著低于透析前（P<0.05）。透析治疗期间，HD组和HFHD组患者的并发症总发生率分别为25.00%（10/40）、15.00%（6/40），2组患者的并发症总发生率比较差异无统计学意义（χ2=1.250，P>0.05）。
结论　相较于常规的HD，HFHD诱发老年终末期肾病患者机体产生的氧化应激反应和微炎症状态更轻，可更有效地保护患者残余肾功能，且未增加并发症的发生，值得临床推广使用。
Abstract:
Objective　To investigate the effect of high-flux hemodialysis (HFHD) on oxidative stress and microinflammatory status in elderly patients with end-stage renal disease.
Methods　A total of 80 elderly patients with end-stage renal disease who received hemodialysis (HD) treatment at Ningde Municipal Hospital of Ningde Normal University from June 2020 to June 2022 were selected as the research subjects.According to the treatment method,the patients were divided into the HD group and HFHD group,with 40 cases in each group.Before and 6 months after dialysis,serum malondialdehyde (MDA),myeloperoxidase (MPO) and superoxide dismutase (SOD) levels were measured by visible spectrophotometer;the serum C-reactive protein (CRP),interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α）were detected by enzyme-linked immunosorbent assay,the serum creatinine (Scr) and blood urea nitrogen (BUN) levels were detected by fully automated biochemical analyzer.The occurrence of complications of patients during HD in the two groups was recorded.
Results　Before dialysis,there was no significant difference in serum MDA,MPO and SOD levels of patients between the two groups (P>0.05);after 6 months of dialysis,the serum MDA and MPO levels of patients in the HFHD group were significantly lower than those in the HD group,while the serum SOD level was significantly higher than that in the HD group (P<0.05);the serum MDA and MPO levels of patients in the two groups after 6 months of dialysis were significantly higher than those before dialysis,while the serum SOD level was significantly lower than that before dialysis (P<0.05).Before dialysis,there was no significant difference in the serum CRP,IL-6 and TNF-α of patients between the two groups (P>0.05);after 6 months of dialysis,the serum CRP,IL-6 and TNF-α levels of patients in the HFHD group were significantly lower than those in the HD group (P<0.05);the serum CRP,IL-6 and TNF-α levels of patients in the two groups after 6 months of dialysis were significantly higher than those before dialysis (P<0.05).Before dialysis,there was no significant difference in Scr and BUN levels of patients between the two groups (P>0.05);after 6 months of dialysis,the Scr and BUN levels of patients in the HFHD group were significantly lower than those in the HD group (P<0.05);the Scr and BUN levels of patients in the two groups after 6 months of dialysis were significantly lower than those before dialysis (P<0.05).During dialysis treatment,the total incidence of complications of patients in the HD group and HFHD group was 25.00% (10/40) and 15.00% (6/40),respectively.There was no significant difference in the total incidence of complications of patients between the two groups（χ2=1.250,P>0.05).
Conclusion　Compared to conventional HD,HFHD induces a milder oxidative stress response and microinflammatory state in the body of elderly end-stage renal disease patients,which can more effectively protect residual renal function without increasing the occurrence of complications and is worthy of clinical promotion and use.

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更新日期/Last Update: 2023-11-05