【摘要】 目的:探讨高通量血液透析对尿毒症维持性血液透析(MHD)患者体内脂肪细胞型脂肪酸结合蛋白(A-FABP)、单核细胞趋化蛋白(MCP-1)、白介素-6(IL-6)及颈动脉粥样斑块的影响。方法:选取2014年6月-2016年6月本院确诊为尿毒症并需MHD治疗的患者60例,治疗前均行颈动脉B超探查,根据颈动脉斑块阳性、阴性情况将其平均分为高通量透析(HFHD)组和普通血液透析(HD)组,各30例,另选取同期健康人30例为对照组。HFHD组行高通量血液透析,HD组行普通血液透析。观察HD组和HFHD组治疗前、治疗后6个月及对照组A-FABP、MCP-1、IL-6水平及颈动脉B超检查指标。结果:治疗前,HFHD组和HD组A-FABP、MCP-1、IL-6水平、颈动脉粥样斑块面积、颈动脉斑块发生率及IMT均高于对照组,颈动脉内径及血流均低于对照组,比较差异均有统计学意义(P<0.05);治疗后,HFHD组A-FABP、MCP-1、IL-6水平、颈动脉粥样斑块面积、IMT均低于治疗前,比较差异均有统计学意义(P<0.05)。结论:尿毒症行MHD的患者为动脉粥样硬化、心血管疾病的高危人群,HFHD在减轻炎症反应、改善动脉粥样硬化中有积极作用,能降低心血管事件发生率和MHD患者死亡率。更多还原

【Abstract】 Objective:To investigate the effects of high flux hemodialysis dialysis on adipocyte fatty acid binding protein(A-FABP),monocyte chemoattractant protein(MCP-1),interleukin-6(IL-6) and carotid atherosclerotic plaque in patients with maintenance hemodialysis dialysis(MHD).Method:A total of 60 patients who diagnosed with uremia and treated with MHD in our hospital from June 2014 to June 2016 were selected,carotid artery B ultrasonic exploration was performed before treatment,according to the positive and negative carotid plaque,they were divided into high flux hemodialysis dialysis(HFHD) group and common hemodialysis dialysis(HD) group,30 cases in each group,and 30 healthy persons in the same period were selected as control group.HFHD group was treated with high flux hemodialysis dialysis,and HD group was treated with common hemodialysis dialysis.The levels of A-FABP,MCP-1,IL-6 and carotid ultrasonography in HD group and HFHD group before and after treatment 6 months and control group were observed.Result:Before treatment,the levels of A-FABP,MCP-1 and IL-6,plaque area of carotid artery,incidence of carotid plaques and IMT in HFHD group and HD group were all higher than those of the control group,and the diameters and blood flow of carotid artery were all lower than those of the control group,the differences were statistically significant(P<0.05).After treatment,the levels of A-FABP,MCP-1,IL-6,plaque area of carotid artery and IMT in HFHD group were all lower than those of before treatment,the differences were statistically significant(P<0.05).Conclusion:Uremia patients with MHD is a high risk group of atherosclerosis and cardiovascular disease,HFHD plays an active role in alleviating inflammatory response and improving atherosclerosis,can reduce the incidence of cardiovascular events and the death rate of MHD patients.更多还原