不同血液透析方式对患者营养及微炎症状态的影响

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摘要目的: 探讨不同血液透析方式对维持性血液透析患者营养及微炎症状态的影响。方法: 将52例规律血液透析患者随机分成3组，分别为血液透析组(HD组，24例)，血液透析联合血液透析滤过组(HD+HDF组，14例)和血液透析联合血液灌流组(HD+HP组，14例)。治疗1年，比较3组患者治疗前后营养不良炎症评分(MIS)、C反应蛋白(CRP)、白蛋白、前白蛋白、血红蛋白、握力、肱三头肌皮褶厚度(TSF)的变化。结果：治疗1年后，HD+HDF组和HD+HP组MIS、CRP均明显低于HD组(P均<0.05)；HD+HDF组前白蛋白、CRP、握力、TSF均较HD组明显上升(P均<0.05)；HD+HP组MIS、前白蛋白、CRP、握力较HD组明显上升(P<0.05)，但TSF差别无统计学意义；HD+HDF组与HD+HP组相比，各指标间差异均无统计学意义(P均>0.05)。HD组治疗后仅血红蛋白水平较治疗前明显上升，MIS、前白蛋白、血红蛋白、握力和TSF较治疗前略有好转，但差异均无统计学意义；HD+HDF组的MIS、白蛋白、前白蛋白、CRP、血红蛋白、握力、TSF均较治疗前有所好转(P均<0.05)；HD+HP组的MIS、前白蛋白、CRP、握力较治疗前相比，差异均有统计学意义(P均<0.05)。结论：血液透析联合血液透析滤过、血液透析联合血液灌流较普通血液透析可更好地改善患者的营养状态，减轻微炎症反应。

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关键词 ：血液透析滤过, 血液灌流, 营养状态, 微炎症

Abstract：Objective: To investigate the impact of different dialysis modalities on the nutrition status and microinflammation of maintenance hemodilysis patients. Methods: Fiftytwo hemodilysis patients were randomly divided into three groups and received hemodialysis(the HD group, 24 cases), hemodiafihration and hemodialysis (the HD+HDF group, 14 cases), and hemodialysis and hemoperfusion(the HD+HP group, 14 cases), respectively, for one year. The malnutrition inflammation score (MIS), C-reactive protein (CRP), serum albumin (ALB), prealbumin (PA), hemoglobin (Hb), handgrip strength, brachial three triceps skinfold thickness (TSF) before and after treatment among the three groups were compared. Results: After one year of treatment, MIS and CRP of the HD+HDF group and the HD+HP group were remarkably lower than that of the HD group(P<0.05); PA, ALB, CRP and TSF were significantly increased in the HD+HDF group compared with the HD group (P<0.05); PA, CRP, handgrip strength were markedly increased in the HD+HP group compared with the HD group (P<0.05), while there was no significant difference in TSF. No significant differences in all indices between HD+HDF group and HD+HP group were found( both P>0.05). Compared with the pre-treatment indices, only Hb markedly increased in HD group(P<0.05), MIS, ALB, PA, CRP, handgrip strength, TSF slightly improved, but there were no significant differences (P>0.05); MIS, ALB, PA, CRP, HB, handgrip strength, TSF notably increased in comparison with pretreatment in HD+HDF group (both P<0.05); and PA, CRP, handgrip strength notably increased in comparison with pre-treatment in HD+HP group (both P<0.05). Conclusion: Hemodiafiltration or hemoperfusion associated with hemodilysis could improve nutrition status and reduce microinflammation better.

收稿日期: 2014-02-07

作者简介: 胡永玮（1983—），男，安徽巢湖人，主治医师，硕士，主要从事肾脏疾病的研究。

引用本文:

胡永玮，宋素珍，闵群燕，邵敏. 不同血液透析方式对患者营养及微炎症状态的影响[J]. 江苏大学学报:医学版, 2014, 24(02): 134-138. HU Yong-wei, SONG Su-zhen, MIN Qun-yan, SHAO Min. Impact of different dialysis modalities on nutrition status and microinflammation of maintenance hemodilysis patients. Journal of Jiangsu University(Medicine Edition), 2014, 24(02): 134-138.

链接本文:

http://zzs.ujs.edu.cn/xbyxb/CN/ 或 http://zzs.ujs.edu.cn/xbyxb/CN/Y2014/V24/I02/134

\[1\]Stenvinkel P, Heimbürger O, Paultre F, et al. Strong association between malnutrition, inflammation, and atherosclerosis in chronic renal failure\[J\]. Kidney Int, 1999, 55(5): 1899-1911.
\[2\]Kopple JD. Effect of nutrition on morbidity and mortality in maintenance dialysis patients\[J\]. Am J Kidney Dis, 1994, 24(6): 1002-1009.
\[3\]Shinaberger CS, Kilpatrick RD, Regidor DL, et al. Longitudinal associations between dietary protein intake and survival in hemodialysis patients\[J\]. Am J Kidney Dis, 2006, 48(1): 37-49.
\[4\]郑智华，马祖，张涤华，等.血液透析患者营养状态与生存质量关系研究\[J\]. 中国血液净化， 2005， 4(4): 187-190.
\[5\]Detsky AS, Mclaughlin JR, Baker JP, et al. What is subjective global assessment of nutritional status\[J\]. JPEN, 1987, 11(1): 8-13.
\[6\]景秀琛，丁峰，薛骏. 改良主观全面营养评价法在血液透析患者中的应用\[J\]. 肾脏病与透析肾移植杂志， 2002， 11(3)： 240-244.
\[7\]王文龙，李云生，程勇军.维持性血液透析患者三种营养状况评估方法的比较研究\[J\]. 中国中西医结合肾病杂志， 2012， 13(11)： 976-980.
\[8\]陈桑，黄雯.不同血液透析方式对维持性血液透析患者营养状态的影响\[J\]. 中国全科医学， 2011， 14(9C)： 3089-3091.
\[9\]刘新君.血液透析联合血液灌流对维持性血液透析患者营养状况及血脂的影响\[J\]. 海南医学， 2013， 24(1)： 28-30.
\[10\]刘琨，叶悦.血清前白蛋白检测在维持性血液透析患者中的意义\[J\]. 临床肾脏病杂志， 2011， 11(10)： 451-453.
\[11\]付荣国，桂保松，王莉，等.不同血液净化方式透析效果及对营养状态的影响\[J\]. 西安交通大学学报：医学版， 2006， 27(4)： 414-416.
\[12\]Fouque D, Vennegoor M, ter Wee P, et al. EBPG guideline on nutrition\[J\]． Nephrol Dial Transplant, 2007, 22(Suppl 2): ii45-ii87.
\[13\]Qureshi AR． Factors predicting malnutrition in hemodialysis： a cross sectional study\[J\]． Kidney Int， 1998， 53(3)： 773-782．
\[14\]陶英，薛军，陈烨.血液透析滤过对维持性血液透析合并心力衰竭患者微炎症和心功能的影响\[J\]. 中国血液净化， 2011， 10(3)： 143-145.
\[15\]张红燕，武子霞.乔佑杰.不同血液净化方式对维持性血液透析患者营养及微炎症状态的影响\[J\]. 山东医药， 2012， 52(18)： 76-77.
\[16\]Filiopoulos V, Hadjiyannakos D, Metaxaki P, et al． Inflammation and oxidative stress in patients on hemodiafiltration\[J\]． Am J Nephrol, 2008, 28(6)： 949-957．