血液透析滤过对糖尿病肾衰竭患者微炎性反应和胰岛素抵抗的影响
发表时间:2014-05-06 浏览次数:1223次
王维平,熊长青,朱 鹏. 血液透析滤过对糖尿病肾衰竭患者微炎性反应和胰岛素抵抗的影响[J].吉林医学,2014,35(13):2776-2778
血液透析滤过;炎性反应;胰岛素抵抗
王维平,熊长青,朱 鹏
江苏省扬州市江都人民医院肾内科,江苏 扬州 225200
2014
2776-2778
知网,万方
目的:观察血液透析滤过对糖尿病维持性血液透析患者微炎性反应和胰岛素抵抗的影响。方法:选择糖尿病肾病血液透析患者56例,病情稳定,已排除急性感染及其他活动性疾病。随机分为常规血液透析组(27例)和血液透析滤过组(29例)。治疗6个月,分别观察两组患者治疗前后hsCRP、IL-6、甲状旁腺素(PTH)和稳态模型胰岛素抵抗指数(HOMA-IR)。结果:HOMA-IR与hsCRP、IL-6相互之间呈正相关(P0.05)。结论:MHD患者存在微炎性反应状态和胰岛素抵抗,血液透析滤过较低通量透析能明显改善糖尿病维持性血液透析患者微炎性反应状态和胰岛素抵抗。 ObjectiveTostudytheeffectsofhemodiafiltrationoninflammationandinsulinresistanceindiabetickidneydiseasepa-tientswithmaintenancehemodialysis.MethodFifty-sixdiabeticpatientswithmaintenancehemodialysiswereselected,whohadunderg-onehemodialysisformorethanthreemonthsandwereinastableclinicstatuswithoutsignsofacuteinfectionsorotherprogressivedisea-ses.Thesepatientsweredividedintotwogroups:theHDgroup(treatedwithHD,n=27)andtheHDFgroup(treatedwithHDFinadditiontoHD,n=29).Patientsineachgroupweretreatedfor6months.SerumIL-6,hsCRPandPTHweremeasuredatthestartandendofthestudy.Insulinresistancewasassessedbyusingthehomeostasismodelassessment(HOMA-IR).ResultsIndiabeticpatientswithmainte-nancehemodialysis,after6monthobservation,thelevelsofHOMA-IR、IL-6hsCRPandPTHinHDFgroupweresignificantlydecreasedaccordingtoHDgroup(P