尿毒症患者血清氧化蛋白产物水平及不同透析方式的清除效果

目的分析尿毒症患者血清氧化物蛋白产物水平与不同血液透析方式的清除效果。方法将尿毒症患者120例随机分成3组:HD组(单纯的血液透析)、HD+HP组(血液透析+血液灌流)、HD+HDP组(血液透析+血液透析过滤),每组各40例患者,同时以同期健康人、尿毒症没有进行透析者各40例作为参照。对尿毒症患者和健康组的D-二聚体、FIB(纤维蛋白原)、CRP(C反应蛋白)等指标进行检测。同时记录尿毒症患者血液透析前后血清氧化蛋白产物与颈动脉粥样斑块的变化。结果血液透析组与尿毒症没有透析组的D-二聚体、FIB、CRP、氧化蛋白产物指标明显高于健康组(P均0.05),且血液透析组患者的指标高于尿毒症没有透析组(P0.05)。1年后,HD+HP组与HD+HDP组患者血清氧化蛋白产物比HD组更低(P均0.05),且粥样斑块面积更小(P均0.05),颈动脉内膜厚度增加值更少(P均0.05)。结论 HD+HP和HD+HDP模式均能有效清除血清氧化蛋白产物和D-二聚体、FIB、CRP等指标,且HD+HDP模式清除氧化蛋白产物的效果更佳,有利于动脉粥样硬化的延缓。

Study on scavenging effect of protein oxidation products with different dialysis in uremic patients

Objective To analyze the scavenging effect on serum protein oxidized products by different ways of hemodialysis in uremic patients. Methods A total of 120 patients with uremia were allocated in this study,and they were randomly divided into three groups： HD group（ simple hemodialysis）,HD ＋ HP group（ hemodialysis plus blood perfusion） and HD ＋ HDP group（ additionally added with hemodialysis and hemodiafiltration）,40 patients in each group. Forty healthy persons in the same period and 40 uremic cases without going dialysis were listed as control groups for reference. D-dimer,FIB,CRP and other indicators were detected in uremic patients and healthy controls. The serum oxidation protein products and changes in plaque of carotid artery were also recorded in uremic patients after hemodialysis. Results In comparison with healthy group,the serum protein oxidized products in patients with dialysis were higher（ P〈0. 05）,they were significantly higher in dialysis group than those without dialysis（ P〈0. 05）. One year later,serum protein oxidized products in HD ＋ HP group and HD ＋ HDP group were lower than those of HD group,and the difference between these groups was statistically significant（ P〈0. 05）. Conclusion HD ＋ HP and HD ＋HDP model can effectively remove serum oxidation protein products and D-dimer,FIB,CRP and other indicators,and the HD ＋ HDP mode Clear oxidation protein products better,in favor of atherosclerosis delay.