本文選題：血液透析濾過 + 維持性血液透析��； 參考：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:本研究旨在探討血液透析濾過(HDF)對(duì)維持性血液透析(MHD)患者紅細(xì)胞免疫粘附功能及氧親和力的影響。方法:1.選取2016年10月至2016年12月在廣西醫(yī)科大學(xué)第一附屬醫(yī)院血液凈化中心治療的MHD患者28例為病例組,同期健康體檢者20例為健康對(duì)照組。2.MHD患者均接受4小時(shí)HDF治療1次,治療參數(shù)如下:均采用前稀釋置換法、碳酸氫鹽透析液透析,血流量250-300ml/min,透析液流量500ml/min,置換液流量125-150ml/min。3.采用紅細(xì)胞花環(huán)試驗(yàn)檢測(cè)紅細(xì)胞免疫粘附功能的指標(biāo),即紅細(xì)胞C3b受體花環(huán)率(E-C3bRR)與紅細(xì)胞免疫復(fù)合物花環(huán)率(E-ICRR);采用酶聯(lián)免疫吸附試驗(yàn)(ELisa)檢測(cè)血紅蛋白氧親和力的指標(biāo),即紅細(xì)胞2,3-二磷酸甘油酸(2,3-DPG);同時(shí)檢測(cè)血肌酐、尿素氮、β2-微球蛋白(β2-MG)、二氧化碳結(jié)合力、血磷、血鉀等生化指標(biāo)。4.檢測(cè)MHD患者HDF治療前、后E-C3bRR、E-ICRR、紅細(xì)胞2,3-DPG及血生化指標(biāo)。檢測(cè)健康體檢者E-C3bRR、E-ICRR。5.比較MHD患者HDF治療前、后E-C3bRR、E-ICRR、紅細(xì)胞2,3-DPG及血生化指標(biāo)的差異;比較MHD患者HDF治療前、后E-C3bRR、E-ICRR與健康對(duì)照組間的差異。結(jié)果:1.MHD患者HDF治療前、后E-C3bRR、E-ICRR均較健康對(duì)照組降低(P0.05);2.MHD患者HDF治療后E-C3bRR較HDF治療前升高(P0.05);3.MHD患者HDF治療前、后E-ICRR及紅細(xì)胞2,3-DPG無變化(P0.05);4.與HDF治療前相比,MHD患者HDF治療后二氧化碳結(jié)合力升高(P0.001),血肌酐、尿素氮、β2-MG、血磷均降低(P0.001)。結(jié)論:MHD患者紅細(xì)胞免疫粘附功能下降,識(shí)別、粘附、清除循環(huán)免疫復(fù)合物能力降低,單次HDF治療能提高M(jìn)HD患者紅細(xì)胞免疫粘附活性,但不改變紅細(xì)胞血紅蛋白氧親和力。
[Abstract]:Objective: to investigate the effect of hemodiafiltration (HDF) on erythrocyte immune adherence and oxygen affinity in patients with maintenance hemodialysis (MHD). Method 1: 1. From October 2016 to December 2016, 28 MHD patients treated in the blood purification center of the first affiliated Hospital of Guangxi Medical University were selected as the case group, and 20 healthy persons as the healthy control group. The parameters were as follows: predilute replacement, bicarbonate dialysate dialysis, blood flow 250-300ml / min, dialysate 500ml / min, replacement fluid 125-150ml / min.3. Erythrocyte rosette test was used to detect erythrocyte immune adherence function, namely erythrocyte C3b receptor rosette rate (E-C3bRR) and erythrocyte immune complex rosette rate (E-ICRRR), and enzyme linked immunosorbent assay (Elisa) to detect hemoglobin oxygen affinity. The biochemical indexes of blood creatinine, urea nitrogen, 尾 2-microglobulin (尾 2-MGG), carbon dioxide binding capacity, blood phosphorus and blood potassium were determined. Before and after HDF treatment, the levels of E-C3bRRRN E-ICRRRR, erythrocyte 23-DPG and blood biochemical indexes were measured in MHD patients. E-C3bRRN E-ICRR.5. Before and after HDF treatment, the differences of E-ICRRR, erythrocyte 23-DPG and blood biochemical indexes in MHD patients were compared, and the differences between E-C3bRRRrr-E-ICRR and healthy controls before and after HDF treatment in MHD patients were compared. Results 1. Before and after HDF treatment, E-C3bRRRN E-ICRR in MHD patients was significantly lower than that in healthy controls. 2. After HDF treatment, E-C3bRR in MHD patients was higher than that in HDF patients before HDF treatment, but there was no change in E-ICRR and erythrocyte 23-DPG in MHD patients before and after HDF treatment. Compared with those before HDF treatment, the carbon dioxide binding capacity of MHD patients increased P0.001C, serum creatinine, urea nitrogen, 尾 2-MGand blood phosphorus decreased P0.001g. Conclusion the erythrocyte immune adherence function of MHD patients was decreased, and the ability to recognize, adhere and clear the circulating immune complex was decreased. Single HDF therapy could improve erythrocyte immune adherence activity, but did not change the oxygen affinity of erythrocyte hemoglobin in MHD patients.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R692.5

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 林建;郭聶濤;;慢性腎衰竭患者紅細(xì)胞補(bǔ)體受體1型分子及其基因多態(tài)性變化[J];包頭醫(yī)學(xué)院學(xué)報(bào);2015年06期

2 陳文成;付瑞全;農(nóng)樂根;韋葉生;韋瑩慧;王俊利;黃衍強(qiáng);黃燕;;瘧疾感染人群紅細(xì)胞黏附功能研究[J];右江醫(yī)學(xué);2014年02期

3 黃韻;戴越剛;王劍;顧嵐;;兒童系膜增生性腎小球腎炎紅細(xì)胞免疫黏附功能的實(shí)驗(yàn)研究[J];檢驗(yàn)醫(yī)學(xué);2013年11期

4 陳鄒陽;;尿毒癥血液透析患者透析前、后免疫因子變化情況[J];國(guó)際檢驗(yàn)醫(yī)學(xué)雜志;2013年19期

5 胡金川;田亞平;江朝光;溫新宇;高艷紅;董矜;郭廣宏;王玲;董振南;;紅細(xì)胞補(bǔ)體受體1分子水平及其基因單核苷酸多態(tài)性與系統(tǒng)性紅斑狼瘡的關(guān)聯(lián)研究[J];醫(yī)學(xué)研究生學(xué)報(bào);2013年07期

6 陳文成;農(nóng)樂根;韋葉生;王俊利;潘云;黎作茶;潘國(guó)剛;黃衍強(qiáng);;桂西地區(qū)少數(shù)民族瘧疾感染人群紅細(xì)胞CD35、CD55分子表達(dá)研究[J];中華疾病控制雜志;2013年07期

7 夏春英;姚利群;邵維斌;李倩;荀康;朱莉;彭淑娟;;慢性腎臟病患者紅細(xì)胞免疫功能異常及相關(guān)因素探討[J];現(xiàn)代醫(yī)學(xué);2013年02期

8 王靚;馮曉晨;高弼虎;;血液透析患者紅細(xì)胞免疫功能研究[J];中國(guó)綜合臨床;2012年09期

9 夏蓉暉;趙綿松;左曉霞;張舸;王玉華;;紅細(xì)胞1型補(bǔ)體受體在系統(tǒng)性紅斑狼瘡患者中的表達(dá)及意義[J];山西醫(yī)科大學(xué)學(xué)報(bào);2012年05期

10 顧嵐;何威遜;宋國(guó)英;張潔;李軍;馬巖;;紅細(xì)胞免疫黏附功能在兒童IgA腎病中的作用[J];實(shí)用兒科臨床雜志;2010年17期

，

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