高低通量血液透析对维持性血液透析患者微炎症、碱性磷酸酶水平和冠状动脉钙化的影响
| 作者: |
1王颖,
1何华妮,
1杨海龙,
1周仕冲
1 琼海市人民医院血液净化室，海南 琼海 571400 |
| 通讯: |
王颖
Email: 420481381@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2023.221074 |
摘要
目的：探讨血液透析低通量与高通量模式对维持性血液透析(maintenance hemodialysis，MHD)患者炎症因子和碱性磷酸酶(alkaline phosphatase，ALP)水平以及冠状动脉钙化(coronary artery calcification，CAC)的影响。方法：100例MHD患者随机被分为低通量组(n=50)与高通量组(n=50)，分别予以低通量透析模式和高通量透析模式。两组均每周进行3次透析，每次持续4 h，连续治疗6个月。比较两组血磷、血钙、全段甲状旁腺激素(intact parathyroid hormone，iPTH)、炎症因子[白细胞介素-6(interleukin-6，IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α，TNF-α)、C反应蛋白(C-reactive protein，CRP)]、CAC相关指标[冠状动脉钙化积分(coronary artery calcification score，CACS)、ALP]和并发症情况。结果：治疗后，高通量组血磷、iPTH均明显低于低通量组(均P0.05)。治疗后，高通量组血清IL-6、TNF-α、CRP水平均显著低于低通量组(均P<0.05)。治疗后，两组CACS相比治疗前均增高(均P<0.05)，但高通量组低于低通量组(P<0.05)，并且高通量组血清ALP水平低于低通量组(P<0.05)。结论：高通量血液透析相比低通量血液透析能够有效地清除血磷、iPTH，改善微炎症状态，降低ALP水平，延缓CAC进程。
关键词：
慢性肾脏病；血液透析；高通量；低通量；炎症；冠状动脉钙化；碱性磷酸酶
Effects of high- or low-flux hemodialysis on microinflammation, alkaline phosphatase level and coronary calcification in maintenance hemodialysis patients
CorrespondingAuthor: WANG Ying Email: 420481381@qq.com
DOI: 10.3978/j.issn.2095-6959.2023.221074
Abstract
Objective: To investigate the effects of low and high flux hemodialysis models on inflammatory factors, and alkaline phosphatase (ALP) levels and coronary artery calcification (CAC) in maintenance hemodialysis (MHD) patients.
Methods: A total of 100 MHD patients were randomly divided into a low-flux group (n=50) and a high-flux group (n=50), and they were treated with low-flux dialysis mode and high-flux dialysis mode, respectively. Both groups underwent dialysis for 4 hours 3 times a week. And the treatment lasted for 6 months. Blood phosphorus, blood calcium, intact parathyroid hormone (iPTH), inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP)], CAC-related indicators [coronary artery calcification score (CACS), ALP] and complications were compared between the 2 groups.
Results: After treatment, the levels of serum phosphorus and iPTH in the high-flux group were significantly lower than those in the low-flux group (both P0.05). After treatment, the levels of serum IL-6, TNF-α, and CRP in the high-flux group were significantly lower than those in the low-flux group (all P<0.05). After treatment, the CACS scores of the 2 groups were higher than those before treatment (both P<0.05), but CACS scores in the high-flux group were lower than those of the low-flux group (P<0.05), and the serum ALP level of the high-flux group was lower than that of the low-flux group (P<0.05).
Conclusion: Compared with low-flux hemodialysis, high-flux hemodialysis can effectively remove blood phosphorus and iPTH, improve microinflammatory state, reduce ALP level, and delay CAC process.
Keywords：
chronic kidney disease; hemodialysis; high flux; low flux; inflammation; coronary artery calcification; alkaline phosphatase
Methods: A total of 100 MHD patients were randomly divided into a low-flux group (n=50) and a high-flux group (n=50), and they were treated with low-flux dialysis mode and high-flux dialysis mode, respectively. Both groups underwent dialysis for 4 hours 3 times a week. And the treatment lasted for 6 months. Blood phosphorus, blood calcium, intact parathyroid hormone (iPTH), inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP)], CAC-related indicators [coronary artery calcification score (CACS), ALP] and complications were compared between the 2 groups.
Results: After treatment, the levels of serum phosphorus and iPTH in the high-flux group were significantly lower than those in the low-flux group (both P0.05). After treatment, the levels of serum IL-6, TNF-α, and CRP in the high-flux group were significantly lower than those in the low-flux group (all P<0.05). After treatment, the CACS scores of the 2 groups were higher than those before treatment (both P<0.05), but CACS scores in the high-flux group were lower than those of the low-flux group (P<0.05), and the serum ALP level of the high-flux group was lower than that of the low-flux group (P<0.05).
Conclusion: Compared with low-flux hemodialysis, high-flux hemodialysis can effectively remove blood phosphorus and iPTH, improve microinflammatory state, reduce ALP level, and delay CAC process.