血液透析联合血液灌流对慢性肾衰竭尿毒症患者微炎症状态及CVC发生的影响

doi:10.3969/j.issn.1671-7171.2025.11.013

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摘要 【目的】探讨血液透析(HD)联合血液灌流对慢性肾衰竭尿毒症患者微炎症状态相关指标及心脏瓣膜钙化(CVC)发生的影响。【方法】156例慢性肾衰竭尿毒症患者,随机分为对照组(采用HD治疗)和观察组(采用HD联合血液灌流治疗),每组78例。比较两组治疗前和治疗3个月后微炎症状态指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)和高敏C反应蛋白(hs-CRP)]、血尿素氮(BUN)、血肌酐(SCr)、β2-微球蛋白(β2-MG)、甲状旁腺素(PTH)、血钾(K⁺)、血钙(Ca²⁺)、内皮素(ET)和血管紧张素Ⅱ(AngⅡ)水平,并比较两组患者血液净化期间CVC发生情况。【结果】治疗后,两组IL-6、IL-10、TNF-α、hs-CRP及BUN、SCr、β2-MG、PTH、K⁺、ET、AngⅡ较治疗前均降低(P<0.05),且观察组低于对照组(P<0.05);两组Ca²⁺较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。两组治疗后CVC发生率比较,差异无统计学意义(P>0.05)。【结论】HD联合血液灌流治疗能够抑制慢性肾衰竭尿毒症患者微炎症反应,调节钙磷钾代谢异常,减轻血管内皮功能损伤,且对CVC的发生并无显著影响。

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	麻世靖
	魏起超
	吴文丽
	田其生

关键词 ：肾功能衰竭,慢性, 尿毒症, 肾透析, 血液灌注

Abstract：【Objective】 To investigate the effect of hemodialysis (HD) combined with hemoperfusion on microinflammatory state–related markers and the risk of cardiac valve calcification (CVC) in patients with chronic renal failure and uremia.【Methods】 A total of 156 patients with chronic renal failure and uremia were randomly divided into a control group (the HD alone) and an observation group (the HD combined with hemoperfusion), with 78 cases in each group. Levels of microinflammatory markers [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6),interleukin-10(IL-10), and high-sensitivity C-reactive protein (hs-CRP)], blood urea nitrogen (BUN), serum creatinine (SCr), β2-microglobulin (β2-MG), parathyroid hormone (PTH), serum potassium (K⁺), serum calcium (Ca²⁺), endothelin (ET), and angiotensin Ⅱ (AngⅡ) were compared between the two groups before treatment and 3 months after treatment. The incidence of CVC during blood purification was also compared.【Results】 After treatment, levels of IL-6, IL-10, TNF-α, hs-CRP, BUN, SCr, β2-MG, PTH, K⁺, ET, and AngⅡ decreased significantly in both groups compared with baseline of pre-treatment (P<0.05), with the observation group showing lower levels than the control group (P<0.05). Ca²⁺ levels increased significantly in both groups after treatment (P<0.05), and the Ca²⁺ level in the observation group was higher than that in the control group (P<0.05). There was no significant difference in the incidence of CVC between the two groups after treatment (P>0.05).【Conclusion】 HD combined with hemoperfusion can suppress microinflammatory responses, regulate calcium, phosphorus, and potassium metabolism abnormalities, and alleviate vascular endothelial dysfunction in patients with chronic renal failure and uremia. However, it has no significant effect on the occurrence of CVC.

Key words： Kidney Failure, Chronic Uremia Renal Dialysis Hemoperfusion

收稿日期: 2023-08-31

中图分类号:

R692.5

通讯作者: *E-mail:tianqisheng12@163.com

引用本文:

麻世靖, 魏起超, 吴文丽, 田其生. 血液透析联合血液灌流对慢性肾衰竭尿毒症患者微炎症状态及CVC发生的影响[J]. 医学临床研究, 2025, 42(11): 1887-1890.
MA Shijing, WEI Qichao, WU Wenli, et al. Effect of Hemodialysis Combined with Hemoperfusion on Microinflammatory State and the Occurrence of Cardiac Valve Calcification in Patients with Chronic Renal Failure and Uremia. JOURNAL OF CLINICAL RESEARCH, 2025, 42(11): 1887-1890.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.11.013 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I11/1887

[1] WANG L M, XU X, ZHANG M, et al. Prevalence of chronic kidney disease in china: results from the sixth China chronic disease and risk factor surveillance[J].JAMA Intern Med,2023,183(4):298-310.
[2] OLSEN E, VAN GALEN G. Chronic renal failure-causes, clinical findings, treatments and prognosis[J].Vet Clin North Am Equine Pract,2022, 38(1):25-46.
[3] SHOSHTARI F S, BIRANVAND S, REZAEI L, et al. The impact of hemodialysis on retinal and choroidal thickness in patients with chronic renal failure[J].Int Ophthalmol,2021, 41(5):1763-1771.
[4] CANAUD B, KÖHLER K, SICHART J M, et al. Global prevalent use, trends and practices in haemodiafiltration[J].Nephrol Dial Transplant,2020, 35(3):398-407.
[5] 中国中西医结合学会肾脏疾病专业委员会. 慢性肾衰竭中西医结合诊疗指南[J].中国中西医结合杂志, 2015, 35(9):1029.
[6] LI J H, LI A L, WANG J L, et al. Early left ventricular dysfunction detected by speckle tracking in long-term hemodialysis patients with valvular calcification[J].Card Med,2019, 9(1):22-30.
[7] JEON H O, KIM J, KIM O. Factors affecting depressive symptoms in employed hemodialysis patients with chronic renal failure[J].Psychol Health Med,2020, 25(8):940-949.
[8] LI L, BO W, CHEN H, et al. Hemoperfusion plus continuous veno-venous hemofiltration in the treatment of patients with multiple organ failure after wasp stings[J].Int J Artif Organs,2020, 43(3):143-149.
[9] 梁敏灵, 秦军建, 高皛磊, 等. 单纯血液透析与杂合型血液净化对老年慢性肾衰竭患者营养状况、机体炎症反应的影响[J].中国老年学杂志, 2020, 40(16):3482-3484.
[10] 唐强帮. 慢性肾功能衰竭患者联合血液透析与血液灌流治疗的效果和安全性评价[J].中国全科医学, 2021, 24(S2):43-45.
[11] 张娜, 张磊, 杜宇, 等. 血液透析、血液滤过、血液灌流不同组合方式治疗慢性肾衰竭尿毒症的临床疗效观察[J].国际泌尿系统杂志, 2021, 41(3):516-519.
[12] 张盛, 雷莉, 韩林, 等. 不同血液净化方式对慢性肾功能衰竭患者树突状细胞和血小板活化标志物表达的影响[J].疑难病杂志, 2022, 21(2):172-177.
[13] PIRKLBAUER M. Hemodialysis treatment in patients with severe electrolyte disorders: management of hyperkalemia and hyponatremia[J].Hemodial Int,2020, 24(3):282-289.
[14] 李小媚. 列线图个体化预测老年慢性肾衰竭血液透析患者发生心脏瓣膜钙化模型的建立[J].临床肾脏病杂志, 2021, 21(4):297-301.
[15] 李文,贾林沛,董星彤,等. 慢性肾脏病非透析患者心脏瓣膜钙化的影响因素及对预后的影响[J].中华肾脏病杂志,2022,38(9):794-801.