【摘要】：目的探討不同血液透析方式對(duì)非糖尿病腎病患者胰島素抵抗(IR)的影響。方法選取徐州市中心醫(yī)院2014年1月至2015年1月收治的非糖尿病腎病透析患者101例,將其分為3組,分別采用高通量血液透析(HFHD)、低通量血液透析(LFHD)和血液透析濾過(HDF)。透析治療6個(gè)月后,比較3組透析患者的臨床資料及生化指標(biāo),并采用Pearson相關(guān)分析及Logistic回歸分析對(duì)穩(wěn)態(tài)模型胰島素抵抗指數(shù)(HOMA-IR))的相關(guān)因素進(jìn)行分析。結(jié)果HDF組和HFHD組的甲狀旁腺素(PTH)水平明顯低于LFHD組,而尿素清除指數(shù)(Kt/V)明顯高于LFHD組(P0.05);HDF組β2-微球蛋白(β2-MG)、空腹胰島素(FINS)水平及HOMR-IR明顯低于HFHD組和LFHD組(P0.05),且HDF組β2-MG清除率(β2-MGCR)明顯高于HFHD組和LFHD組(P0.001)。Pearson相關(guān)分析表明,HOMA-IR與體質(zhì)量指數(shù)(BMI)呈正相關(guān)(r=0.346,P=0.014),與β2-MGCR及高密度脂蛋白膽固醇(HDL-C)呈負(fù)相關(guān)(r=-0.412,P=0.002;r=-0.204,P=0.042)。Logistic回歸性分析表明,BMI(OR=1.538,95%CI:1.364~1.759,P=0.021)和HDF(OR=0.137,95%CI:0.045~0.632,P=0.012)為影響HOMA-IR的獨(dú)立因素。結(jié)論相較于HFHD和LFHD,HDF可以改善非糖尿病腎病透析患者的IR狀態(tài),對(duì)臨床治療具有重要意義。
[Abstract]:Objective to investigate the effect of different dialysis methods on insulin resistance (IR) in patients with non-diabetic nephropathy. Methods 101 patients with non-diabetic nephropathy treated in Xuzhou Central Hospital from January 2014 to January 2015 were divided into three groups. (LFHD) and (HDF). Were treated with high throughput (HFHD), and hemodiafiltration, respectively. After 6 months of dialysis treatment, the clinical data and biochemical indexes of the three groups were compared, and the related factors of insulin resistance index (HOMA-IR) in steady state model were analyzed by Pearson correlation analysis and Logistic regression analysis. Results the level of parathyroxine (PTH) in HDF group and HFHD group was significantly lower than that in LFHD group, while the urea clearance index (Kt/V) was significantly higher than that in LFHD group (P 0.05). The fasting insulin (FINS) and HOMR-IR levels of 尾 2-microglobulin (尾 2-MG),) in HDF group were significantly lower than those in HFHD group and LFHD group (P 0.05), and the clearance rate of 尾 2-MG in HDF group (尾 2-MGCR) was significantly higher than that in HFHD group and LFHD group (P0.001). Pearson correlation analysis showed that HOMA-IR was positively correlated with body mass index (BMI) (r 鈮，

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