王宇静,钟育祥
WANG Yujing,ZHONG Yuxiang

• 1:中南大学湘雅医学院附属海口市人民医院

摘要(Abstract)：

目的:探讨不同血液净化方式对糖尿病肾病(DN)慢性肾衰竭患者血清脂肪因子及炎性因子水平的影响。方法:180例DN慢性肾衰竭患者均分为CBP组(连续性血液净化治疗)及MHP组(维持性血液透析治疗);采用酶联免疫吸附法(ELISA)检测两组患者治疗前后血清脂联素、抵抗素、瘦素、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平,采用简易生存质量量表(SF-36)测评患者生存质量各维度得分和总分。结果:治疗前两组患者血清脂肪因子和炎性因子水平比较差异均无统计学意义(P>0.05),治疗后CBP组患者的脂联素水平显著高于MHP组,抵抗素、瘦素、IL-6、TNF-α水平均显著低于MHP组(P<0.05);CBP组治疗后脂联素水平显著高于治疗前,抵抗素、瘦素、IL-6、TNF-α水平则显著低于治疗前(P<0.05),但MHP组患者治疗前后各指标比较,差异无统计学意义(P>0.05);CBP组患者治疗后的生存质量各维度得分及总分均显著高于MHP组患者,差异有统计学意义(P<0.05)。结论:CBP可以较MHP更有效地调节DN慢性肾衰竭患者的血清脂肪因子和炎症因子水平,提高患者生存质量。
Objective: To investigate the effect of different blood purification methods on levels of serum adipokines and inflammatory factors in patients with diabetic nephropathy and chronic renal fai-lure.Methods:180 patients with diabetic nephropathy and chronic renal failure were randomly divided into continuous blood purification treatment(CBP) group and maintenance hemodialysis treatment(MHP) groups,with 90 patients each.The serum adiponectin,resistin,leptin,inflammatory factors(IL-6) and TNF-α were compared and analyzed in both groups before and after treatment with ELISA assay;quality of life were compared between the two groups with SF-36 for sub scores and total scores of patients.Results:There was no significant difference between the two groups of the levels of adiponectin,and inflammatory factors before treatment(P>0.05).After treatment,adiponectin level in the CBP group was significantly higher than that of the MHP group;resistin,leptin,IL-6 and TNF-α levels were lower than those in the MHP group(P<0.05).Comparison before and after treatment of patients in the same group indicated that adiponectin levels after treatment in CBP group were higher than before treatment,and resistin,leptin,IL-6 and TNF-α levels were lower than before treatment(P<0.05).The indexes before and after treatment of MHP group showed no statistical significant(P<0.05);sub scores and total scores of the quality of life in CBP group after treatment were obviously higher than that of MHP group,differences were statistically significant(P<0.05).Conclusion:Compared with MHP,CBP can regulate the levels of serum adipokines and inflammatory factors of DN patients with chronic renal failure and improve their quality of life.

关键词(KeyWords)： 糖尿病肾病;肾功能衰竭,慢性;脂肪因子类;连续性血液净化;维持性血液透析;炎性因子
diabetic nephropath;chronic renal failure;adipokines;continuous blood purification;maintenance hemodialysis;inflammatory factors

Abstract:

Keywords:

基金项目(Foundation): 海南省自然科学基金面上项目(817384)

作者(Author): 王宇静,钟育祥
WANG Yujing,ZHONG Yuxiang

DOI: 10.19367/j.cnki.1000-2707.2019.08.019

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