血液净化在慢性肾功能衰竭合并糖尿病患者治疗中对脂联素、白细胞介素6及肿瘤坏死因子α的影响及作用
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摘要
目的探究血液净化在慢性肾功能衰竭合并糖尿病患者治疗中对脂联素、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)的影响及作用。方法选取2015年2月至2017年5月期间来该院接受治疗的慢性肾功能衰竭合并糖尿病患者118例,按照数字表随机分成观察组与对照组,每组59例。对照组采用常规慢性肾功能衰竭合并糖尿病治疗方法,观察组在常规治疗基础上采用血液净化治疗;比较分析两组治疗前后血清中脂肪因子脂联素、抵抗素、炎症因子、IL-6、瘦素、TNF-α水平,以及两组治疗前后血糖、血脂指标、生活质量评分。结果两组治疗前脂肪因子脂联素及抵抗素比较,差异无统计学意义(P>0.05);治疗后两组较治疗前均有改善效果,但对照组改善轻微,观察组效果显著,组间比较差异有统计学意义(P<0.05);两组治疗前炎症因子、瘦素、IL-6、TNF-α比较差异无统计学意义(P>0.05),治疗后两组较治疗前比较均有改善效果,但对照组改善轻微,观察组效果显著,组间比较差异有统计学意义(P<0.05);两组[空腹血糖(FBG)、餐后2h血糖(2hPBG)、三酰甘油(TG)、胆固醇(TC)均优于治疗前,但观察组效果更佳,差异有统计学意义(P<0.05)];两组患者经过治疗生活质量均得到改善,组间比较观察组患者的生活质量评分明显高于对照组,差异有统计学意义(P<0.05);对照组评分在"社会"这个维度略高于观察组,但差异无统计学意义(P>0.05)。结论血液净化在慢性肾功能衰竭合并糖尿病患者的治疗中可以有效调节脂联素、IL-6和TNF-α指标水平,更好地控制血糖,提高患者生活质量。
Objective To explore the effect and effect of blood purification on adiponectin,interleukin-6 and tumor necrosis factor-alpha in the treatment of chronic renal failure and diabetes.Methods 118 patients with chronic renal failure and diabetes treated in our hospital from February 2015 to May 2017 were randomly divided into the observation group and the control group,with 59 patients in each group.The control group was treated with conventional chronic renal failure combined with diabetes,and the observation group was treated with blood purification on the basis of conventional treatment.The blood serum levels of adiponectin,resistin and inflammatory factors PTH,IL-6,leptin and TNF-alpha were compared and analyzed in the two groups before and after treatment,and the blood glucose and blood lipid indexes and the quality of life were compared and analyzed between the two groups before and after treatment.Results There was no significant difference between the two groups of adiponectin and resistin before treatment(P>0.05).After treatment,the two groups were better but the control group was slightly improved,the effect of the observation group was significant,and the group was statistically significant(P<0.05);there was no significant difference in inflammatory factors,leptin,IL-6,TNF-αbetween the two groups(P>0.05),after treatment,the two groups were better than before treatment,but the control group was slightly improved,the effect of the observation group was significant,the group was statistically significant(P<0.05);the two groups of patients FBG,2 hPBG,TG,TC were better than before the treatment,but the effect of the observation group was better,the difference between the two groups was statistically significant.Significance(P<0.05);the quality of life of the two groups of patients improved,the score of the quality of life of the patients in the comparison group was significantly higher than that of the control group(P<0.05),although the socre in the "society" dimension in the control group was higher than that in the observation group,but there was no statistical significance(P>0.05).Conclusion Blood purification can effectively improve the level of adiponectin,IL-6 and TNF-alpha in the treatment of chronic renal failure and diabetes,and better control blood sugar and improve the quality of life of the patients.
Objective To explore the effect and effect of blood purification on adiponectin,interleukin-6 and tumor necrosis factor-alpha in the treatment of chronic renal failure and diabetes.Methods 118 patients with chronic renal failure and diabetes treated in our hospital from February 2015 to May 2017 were randomly divided into the observation group and the control group,with 59 patients in each group.The control group was treated with conventional chronic renal failure combined with diabetes,and the observation group was treated with blood purification on the basis of conventional treatment.The blood serum levels of adiponectin,resistin and inflammatory factors PTH,IL-6,leptin and TNF-alpha were compared and analyzed in the two groups before and after treatment,and the blood glucose and blood lipid indexes and the quality of life were compared and analyzed between the two groups before and after treatment.Results There was no significant difference between the two groups of adiponectin and resistin before treatment(P>0.05).After treatment,the two groups were better but the control group was slightly improved,the effect of the observation group was significant,and the group was statistically significant(P<0.05);there was no significant difference in inflammatory factors,leptin,IL-6,TNF-αbetween the two groups(P>0.05),after treatment,the two groups were better than before treatment,but the control group was slightly improved,the effect of the observation group was significant,the group was statistically significant(P<0.05);the two groups of patients FBG,2 hPBG,TG,TC were better than before the treatment,but the effect of the observation group was better,the difference between the two groups was statistically significant.Significance(P<0.05);the quality of life of the two groups of patients improved,the score of the quality of life of the patients in the comparison group was significantly higher than that of the control group(P<0.05),although the socre in the "society" dimension in the control group was higher than that in the observation group,but there was no statistical significance(P>0.05).Conclusion Blood purification can effectively improve the level of adiponectin,IL-6 and TNF-alpha in the treatment of chronic renal failure and diabetes,and better control blood sugar and improve the quality of life of the patients.
引文
[1]张静,郭立华,姜琦,等.胃肠肽激素在慢性肾功能衰竭患者行血液透析后的变化影响[J].现代消化及介入诊疗,2016,21(1):135-137.
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[3] BRETAN P N,BUSCH M P,HRICAK H,et al.Chronic renal failure:a significant risk favtor in the development of acquired renal cysts and renal cell carcinoma-case reports and review of the literature[J].Cancer,1986,57(9):1871-1879.
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[5]赵赛郦,欧阳红娟,李健芝,等.持续质量改进对糖尿病肾病患者血液透析中低血糖的影响[J].中南医学科学杂志,2017,45(2):214-216.
[6] CABIDDU G,CASTELLINO S,GERNONE G,et al.A best practice position statement on pregnancy in chronic kidney disease:the Italian Study Group on Kidney and Pregnancy[J].J Nephrol,2016,29(3):277-303.
[7] HICKSON L J,EIRIN A,LERMAN L O.Challenges and opportunities for stem cell therapy in patients with chronic kidney disease[J].Kidney Int,2016,89(4):767-778.
[8] UDDEN M M,O′REAR E A,KEGEL H,et al.Decreased deform ability of erythrocytes and increased intracellular Calcium in patients with chronic renal failure[J].Clin Hemorheol Microcircul,2016,4(5):473-481.
[9]牟新,庄爱文,马国玲,等.237例临床期糖尿病肾病患者中医证候聚类分析[J].中华中医药学刊,2016,34(2):332-335.
[10]侯洁,许芳,许颖.脂联素与慢性肾脏病的研究进展[J].中华临床医师杂志,2016,10(11):1595-1600.
[11]LERMA C,MINZONI A,INFANTE O,et al.A mathematical analysis for the cardiovascular control adaptations in chronic renal failure[J].Artif Organs,2004,28(4):398-409.
[12]KESIK V,DEMIRKAYA E,BUYUKPAMUKU M.Urinary neutrophil gelatinase associated lipocalin as a biomarker in ifosfamide induced chronic renal failure[J].Eur Rev Med Pharmacol Sci,2015,19(24):4851-4857.
[13]钟春.不同血液净化方式对糖尿病肾病患者脂肪因子、炎症因子的影响[J].海南医学院学报,2016,22(4):340-342.
[14]胡煜琳,李超.不同血液透析方式对慢性肾衰竭患者β2微球蛋白、瘦素、血红蛋白水平的影响及安全性分析[J].重庆医学,2016,45(21):2914-2916.
[15]公帅,孙桂荣,刘明军,等.异常凝血酶原和唾液酸在慢性肾功能不全患者血清中的表达及临床意义[J].国际检验医学杂志,2016,37(7):900-903.
[16]赵洪民.持续血液滤过治疗脓毒血症合并急性肾衰竭疗效观察[J].临床军医杂志,2017,45(7):758-760.
[17]杨冉,王韫芳,张维.利拉鲁肽联合替米沙坦对早期糖尿病肾病患者血中TNF-α、IL-6及TGF-β1水平的影响[J].西部医学,2016,28(2):191-194.
[18]FAGUER S,ESPOSITO L,CASEMAYOU A,et al.Calcineurin inhibitors downregulate HNF-1βand May affect the outcome of HNF1Bpatients after renal transplantation[J].Transplantation,2016,100(9):1970-1978.
[2]于红俊,李建秀,左艳敏,等.附子黄参汤联合结肠透析治疗慢性肾功能衰竭临床疗效分析[J].四川中医,2016,34(5):116-118.
[3] BRETAN P N,BUSCH M P,HRICAK H,et al.Chronic renal failure:a significant risk favtor in the development of acquired renal cysts and renal cell carcinoma-case reports and review of the literature[J].Cancer,1986,57(9):1871-1879.
[4] ZOCCALI C,BENEDETTO F A,MALLAMACI F,et al.Fibrinogen,inflammation and concentric left ventricular hypertrophy in chronic renal failure[J].Eur J Clin Invest,2003,33(7):561-566.
[5]赵赛郦,欧阳红娟,李健芝,等.持续质量改进对糖尿病肾病患者血液透析中低血糖的影响[J].中南医学科学杂志,2017,45(2):214-216.
[6] CABIDDU G,CASTELLINO S,GERNONE G,et al.A best practice position statement on pregnancy in chronic kidney disease:the Italian Study Group on Kidney and Pregnancy[J].J Nephrol,2016,29(3):277-303.
[7] HICKSON L J,EIRIN A,LERMAN L O.Challenges and opportunities for stem cell therapy in patients with chronic kidney disease[J].Kidney Int,2016,89(4):767-778.
[8] UDDEN M M,O′REAR E A,KEGEL H,et al.Decreased deform ability of erythrocytes and increased intracellular Calcium in patients with chronic renal failure[J].Clin Hemorheol Microcircul,2016,4(5):473-481.
[9]牟新,庄爱文,马国玲,等.237例临床期糖尿病肾病患者中医证候聚类分析[J].中华中医药学刊,2016,34(2):332-335.
[10]侯洁,许芳,许颖.脂联素与慢性肾脏病的研究进展[J].中华临床医师杂志,2016,10(11):1595-1600.
[11]LERMA C,MINZONI A,INFANTE O,et al.A mathematical analysis for the cardiovascular control adaptations in chronic renal failure[J].Artif Organs,2004,28(4):398-409.
[12]KESIK V,DEMIRKAYA E,BUYUKPAMUKU M.Urinary neutrophil gelatinase associated lipocalin as a biomarker in ifosfamide induced chronic renal failure[J].Eur Rev Med Pharmacol Sci,2015,19(24):4851-4857.
[13]钟春.不同血液净化方式对糖尿病肾病患者脂肪因子、炎症因子的影响[J].海南医学院学报,2016,22(4):340-342.
[14]胡煜琳,李超.不同血液透析方式对慢性肾衰竭患者β2微球蛋白、瘦素、血红蛋白水平的影响及安全性分析[J].重庆医学,2016,45(21):2914-2916.
[15]公帅,孙桂荣,刘明军,等.异常凝血酶原和唾液酸在慢性肾功能不全患者血清中的表达及临床意义[J].国际检验医学杂志,2016,37(7):900-903.
[16]赵洪民.持续血液滤过治疗脓毒血症合并急性肾衰竭疗效观察[J].临床军医杂志,2017,45(7):758-760.
[17]杨冉,王韫芳,张维.利拉鲁肽联合替米沙坦对早期糖尿病肾病患者血中TNF-α、IL-6及TGF-β1水平的影响[J].西部医学,2016,28(2):191-194.
[18]FAGUER S,ESPOSITO L,CASEMAYOU A,et al.Calcineurin inhibitors downregulate HNF-1βand May affect the outcome of HNF1Bpatients after renal transplantation[J].Transplantation,2016,100(9):1970-1978.
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