糖尿病肾病患者微炎症状态与营养不良的相关性研究

摘要

目的:分析糖尿病肾病患者微炎症状态与营养不良的相关性.方法:选取接受血液透析治疗的糖尿病肾病患者106例,随机分成常规血液透析组和联合血液透析组(常规血液透析+血液灌流),另选取不需接受血液透析治疗的糖尿病肾病患者53例为对照组,分析3组患者治疗前及治疗后3、6、9、12个月血清C-反应蛋白(CRP)、白细胞介素-6(IL-6),血清白蛋白(Alb)、血红蛋白(Hb)、胆固醇(Ch)、血肌酐(SCr)及尿素氮(BUN)水平.结果:①常规透析组中的CRP和IL-6水平低于对照组(均P＜0.05);而联合透析组中的CRP和IL-6水平低于对照组和常规透析组(均P＜0.05).②常规透析组中的Hb、Ch和Alb水平高于对照组(均P＜0.05);联合透析组中的Hb、Ch和Alb水平高于对照组和常规透析组(均P＜0.05).③CRP与IL-6、Hb、Ch和Alb之间有相关性.结论:联合血液透析能改善糖尿病肾病患者微炎症状态与营养不良状况,微炎症指标与营养指标在糖尿病肾病发生过程中有相关性.%Objective: To analyze the relationship between microinflammation and malnutrition in patients with diabetic nephropathy.Methods: 106 cases of diabetic nephropathy receiving hemodialysis in our hospital were selected as the research objects during the period from May 2014 to May 2016,and were randomly divided into routine hemodialysis group and com-bined hemodialysis group(conventional hemodialysis+hemoperfusion).Fifty-three cases of diabetic nephropathy not re-ceiving hemodialysis treatment served as control group.Before and at 3rd,6th,9th and 12th month after treatment,serum C-reactive protein(CRP)and interleukin-6(IL-6),serum albumin(Alb),hemoglobin(Hb),cholesterol(Ch),serum creatinine(SCr),and blood urea nitrogen(BUN)were analyzed by SPSS20.0 statistical software.Results:①The CRP and IL-6 levels in the conventional hemodialysis group were lower than in the control group with the difference being significant between the two groups(P＜0.05).The CRP and IL-6 levels in the combined hemodialysis group were lower than in the control group and conventional hemodialysis group with the difference being significant between the combined hemodialysis group and control group or conventional hemodialysis group(P＜0.05).②Hb,Ch and Alb levels in the conventional hemo-dialysis group were higher than in the control group with the difference being significant between the two groups(P＜0.05).Hb,Ch and Alb levels in combined hemodialysis group were significantly higher than those in control group and conventional hemodialysis group(P＜0.05).③There was a correlation between CRP with IL-6,Hb,Ch and Alb.Conclusion: Com-bined hemodialysis can improve the microinflammatory status and malnutrition in patients with diabetic nephropathy,and there is correlation between microinflammatory indicators and nutritional indicators in the process of diabetic nephropathy.