目的 观察低通量血液透析(LFHD)、高通量血液透析(HFHD)和血液透析滤过(HDF)对维持性血液透析(MHD)患者血清炎症因子的影响.方法 选取MHD患者60例,随机分为LFHD组、HFHD组和HDF组各20例,对照组为20名健康体检者,检测透析前后及透析6月血清CRP、IL-6、IL-8及TNF-α水平.结果 MHD患者透析前血清CRP、IL-6、IL-8及TNF-α水平高于对照组(P＜0.01).LFHD组单次和透析6个月后CRP、IL-6、IL-8及TNF-α水平均不降低(P＞0.05)；HFHD组单次透析后CRP、IL-6、IL-8及TNF-α水平下降不明显(P＞0.05),透析6个月后,CRP、IL-6、IL-8及TNF-α水平下降(P ＜0.05)；HDF组单次和透析6个月后CRP、IL-6、IL-8及TNF-α水平下降(P＜0.05)；透析6个月后,HDF组CRP、IL-6、IL-8及TNF-α水平低于HFHD组同期水平(P＜0.05).结论 MHD患者存在着微炎症状态,HDF和HFHD透析可以降低血清CRP、IL-6、IL-8及TNF-α水平,改善MHD患者微炎症状态,HDF透析优于HFHD.%Objective To study the effects of low-flux hemodialysis (LFHD) , high-flux hemodialysis (HFHD) and hemodiafiltration ( HDF) on the serum inflammatory cytokine in maintenance hemodialysis ( MHD) patients. Methods Sixty MHD patients were randomly divided into LFHD group, HFHD group and HDF group. Results The levels of serum CRP, IL-6, IL-8 and TNF-a were detected in three groups and control group. The results showed that levels of CRP, IL-6, IL-8 and TNF-a in patients with MHD before treatment were much higher than these in control group (P<0.01). The levels of CRP, IL-6, IL-8 and TNF-a did not significantly decrease in patients with LFHD after the first hemodialysis and after the hemodialysis 6 months (P > 0. 05). The levels of CRP, IL-6, IL-8 and TNF-a did not significantly decrease in patients with HFHD after the first hemodialysis (P>0.05).The levels of CRP, IL-6, IL-8 and TNF-a decreased markedly in patients with HFHD after 6 months hemodialysis ( P <0. 05) . The levels of CRP, IL-6, IL-8 and TNF-a decreased significantly in patients with HDF after the first hemodialysis and after 6 months(P <0.05). The levels of CRP, IL-6, IL-8 and TNF-α in HDF group were significantly lower than those in HFHD group after 6 months (P <0. 05). Conclusion There was microinflammatory state in MHD patients. The lowering of patients'serum CRP, IL-6, IL-8 and TNF-a levels and thus the recovery from microinflammatory state may be achieved by HDF, HFHD, and HFHD preferably by HDF.
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