目的: 探讨高通量血液透析对慢性肾衰竭尿毒症患者血清PGI2、MCP-1水平的影响。 方法: 对本院2016年5月至2019年5月收治的慢性肾衰竭尿毒症患者108例,根据随机数字表法分为对照组和观察组,各54例,对照组给予常规血液透析滤过治疗,观察组给予高通量血液透析。治疗1个月后,比较两组患者的血清PGI2、MCP-1、免疫球蛋白、尿毒症毒素以及肺功能水平,监测不良反应,观察患者症状缓解情况。结果: 治疗前两组患者各观察指标均无显著性差异(P＞0.05)。治疗1个月后,两组患者MCP-1水平均有所降低,PGI2水平均有所升高,且观察组显著优于对照组(P＜0.05);两组患者血清免疫球蛋白IgG、IgA、IgM水平均显著升高(P＜0.05),且观察组各免疫球蛋白水平均显著高于对照组(P＜0.05);两组患者尿毒症毒素β2-MG、PTH水平均显著降低(P＜0.05),且观察组患者β2-MG、PTH水平显著低于对照组(P＜0.05);两组患者的肺功能水平均有所好转,且观察组患者显著优于对照组(P＜0.05);治疗过程中,观察组不良反应率7.41 %,治疗有效率92.59 %;对照组不良反应率24.07 %,治疗有效率75.93 %,观察组的治疗效果明显优于对照组。结论: 高通量血液透析治疗慢性肾衰竭尿毒症能够有效提高患者的免疫功能,清除尿毒症毒素,改善肺功能 ,提高PGI2水平,降低MCP-1水平,治疗效果安全有效,值得临床进一步推广。
Objective: To investigate the effect of high-flux hemodialysis on serum PGI2 and McP-1 levels in patients with stage 5 chronic renal failure. Methods: A total of 108 patients with chronic renal failure uremia admitted to our hospital from May 2016 to May 2019 were selected. 108 patients were divided into control group (n=54) and observation group (n=54) with random number table. The control group was treated with routine hemodiafiltration, and the observation group was treated with high-flux hemodialysis. After one month of treatment, the serum levels of PGI2, MCP-1, immunoglobulin, uremia toxin and lung function of the two groups were compared, the adverse reactions were monitored, and indicators of remission were observed. Results: No significant difference on each observation index between the two groups was found before treatment (P＞0.05). After one month of treatment, the levels of MCP-1 in both groups were decreased, and levels of PGI2 were both increased. However, MCP-1 and PGI2 levels in the observation group were significantly better than those in the control group (P＜0.05). Levels of IgG, IgA and IgM in both groups were significantly increased (P＜0.05), and all immunoglobulin levels in the observation group were significantly higher than those in the control group (P＜0.05). The levels of β2-MG and PTH in the two groups were significantly decreased (P＜0.05), and the levels of β2-MG and PTH in the observation group were significantly lower than those in the control group (P＜0.05). The pulmonary function of the two groups were both improved, and the pulmonary function in the observation group was significantly better than that in the control group (P＜0.05). During the treatment, the complication rate of the observation group was 7.41 %, with an effective rate of 92.59 %. The complication rate of the control group was 24.07 %, with an effective rate of 75.93 %. The treatment effect in the observation group was significantly better than that of the control group. Conclusion: High-flux hemodialysis could effectively improve the immune function of patients with stage 5 chronic renal failure, remove uremic toxins, improve lung function, raise the level of PGI2, and reduce the level of MCP-1, which is worthy of further clinical promotion.
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