本文關鍵詞： 尿毒癥 血液透析 免疫指標 血清炎性因子　出處：《現(xiàn)代免疫學》2017年06期 　論文類型：期刊論文

【摘要】：探究尿毒癥血液透析患者透析前后免疫指標及IL-6、CRP、IL-8、TNF-α的變化。抽取2013年4月至2015年10月我院78例尿毒癥患者,隨機數(shù)表法分組,各39例。實驗組采用高通量血液透析(high-flux hemodialysis,HFHD),對照組采用低通量血液透析(low-flux hemodialysis,LFHD),兩組均觀察治療6個月。對比治療前后兩組免疫指標CIgA、IgG、IgM及其C3、C4)、紅細胞免疫指標[紅細胞免疫復合花環(huán)(erythrocyte immune complex rosette,RBC-ICR)、紅細胞免疫抑制率(erythrocyte immunosuppressive rate,RFIR)、紅細胞C3b受體(erythrocyte C3breceptor,RBC-C3bR)、紅細胞免疫促進因子(erythrocyte immune promoting factor,RFER)]、血清炎性因子(IL-6、IL-8、CRP、TNF-α)及營養(yǎng)狀態(tài)指標(PA、ALB、Hb)水平變化情況。(1)免疫指標:治療后兩組IgA、IgG、IgM、C3、C4等指標水平均較治療前增高,且實驗組IgA、IgG、IgM、C3、C4水平高于對照組,差異有統(tǒng)計學意義(P0.05);(2)紅細胞免疫指標:治療后實驗組RBC-ICR、RFIR水平低于對照組,RBC-C3bR、RFER水平高于對照組,差異有統(tǒng)計學意義(P0.05);(3)血清炎性因子:治療后兩組IL-6、IL-8、TNF-α、CRP等指標水平均較治療前降低,且實驗組各指標低于對照組,差異有統(tǒng)計學意義(P0.05);(4)營養(yǎng)狀態(tài):治療后兩組各指標水平均較治療前增高,且實驗組PA、ALB、Hb水平高于對照組,差異有統(tǒng)計學意義(P0.05)。采用血液透析治療尿毒癥患者可有效降低血清炎性因子水平,改善免疫功能及營養(yǎng)狀態(tài),且HFHD效果優(yōu)于LFHD。
[Abstract]:Objective: to investigate the immune index and IL-6 CRP IL-8 in patients with uremia before and after hemodialysis. The changes of TNF- 偽. From April 2013 to October 2015, 78 patients with uremia in our hospital were randomly divided into two groups. The experimental group was treated with high-flux hemodialysis high-flux hemodialysis (HFHD). The control group was treated with low-flux hemodialysis and low-flux hemodialysis for 6 months. The immune index CIgA was compared before and after treatment. IgGN IgM and its C _ 3C _ 4C _ (4), erythrocyte immune Indexes. [Erythrocyte immune complex rosette (RBC-ICR). Erythrocyte immunosuppressive rate and erythrocyte immunosuppressive rateir). Erythrocyte C3b receptor RBC-C3bR. Erythrocyte immune promoting factor (RFER) and serum inflammatory factor IL-6 (IL-8). The changes of the level of CRPnTNF- 偽 and the nutritional status index (PAA) ALB (Hb): after treatment, the two groups were immunized with IgA, IgG, IgM, C 3. The level of C4 was higher than that before treatment, and the level of IgAg C _ 3C _ 3C _ 4 in the experimental group was higher than that in the control group (P < 0.05). (2) erythrocyte immune index: the RFIR level of RBC-ICRN in the experimental group was lower than that in the control group after treatment, and the level of rfer was higher than that in the control group. The difference was statistically significant (P 0.05). 3) Serum inflammatory factors: after treatment, the levels of IL-6, IL-8, TNF- 偽 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. The difference was statistically significant (P 0.05). (4) nutritional status: after treatment, the level of each index in the two groups was higher than that before treatment, and the level of PABBU HB in the experimental group was higher than that in the control group. The difference was statistically significant (P 0.05). Hemodialysis could effectively reduce the level of serum inflammatory factors, improve the immune function and nutritional status, and the effect of HFHD was better than that of LFHD.
【作者單位】： 河北醫(yī)科大學第一醫(yī)院腎內科;
【基金】：河北省衛(wèi)生廳醫(yī)學科學研究課題(20120298)
【分類號】：R692.5
【正文快照】： 現(xiàn)代醫(yī)學認為尿毒癥為患者喪失腎功能后,機體生化過程紊亂而出現(xiàn)的一系列復雜綜合征,其本質是機體無法經(jīng)腎臟產生尿液,進而將機體中代謝廢物與過多水分排出體外,從而引發(fā)毒害[1-2]。血液透析(hemodialysis,HD)為臨床救治尿毒癥患者的主要措施,可取得一定療效,但尿毒癥持續(xù)HD患

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