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高通量透析对维持性血液透析患者抑郁状态的影响
唐冠英王红宇楚修林刘新静唐冠军侯西彬田津生李建峰
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摘要:
目的 观察高通量透析(HFHD)及普通透析(CHD)两种血液净化方式对维持性血液透析 (MHD)患者抑郁程度及相关因子表达的影响。方法 72例MHD患者随机分为HFHD组及CHD组,每组 各36例。入组前及治疗6个月后均于透析后达干体重时应用抑郁自评量表(SDS)进行抑郁评分,并采血 检测白介素6(IL-6)、同型半胱氨酸(Hcy)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平。结果 治疗前两组 患者抑郁评分及IL-6、Hcy、MDA、SOD水平差异无统计学意义(P> 0.05),治疗6个月后,HFHD组抑郁评 分及血IL-6、Hcy、MDA水平较入组前明显下降(P < 0.05),SOD水平较治疗前明显上升(P < 0.05),CHD 组各项指标较入组前无明显改变(P>0.05),两组比较,各项差异有统计学意义(P<0.05)。相关分析显示, MHD患者抑郁评分与IL-6、Hcy、MDA水平呈正相关(r值分别为0.367,0.463,0.769),与SOD水平呈负相 关(r=-0.571)。结论 HFHD较CHD能更有效地清除血IL-6、Hcy、MDA、水平,并升高SOD水平,进而使 患者的抑郁状态缓解。
关键词:  抑郁  高通量透析  普通透析  炎性因子  氧化应激
DOI:10.3969/j.issn.1009-6574.2017.10.008
基金项目:2016 年保定市科学技术研究与发展指导计划项目 (16ZF153)
Effects of high-flux hemodialysis on the depression state in maintenance hemodialysis patients
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Abstract:
Objective To explore the effects of high-flux hemodialysis( HFHD) and convention hemodialysis( CHD) on depression level and concentration of interleukin-6( IL-6), homocysteine( Hcy), malondialdehyde( MDA), superoxide dismutase( SOD) in the serum of maintenance hemodialysis( MHD) patients. Methods A total of 72 MHD patients were divided into HFHD group and CHD group randomly, with 36 patients in each. Before treatment and 6 months after, all the participants were estimated for depression score and concentration of IL-6, Hcy, MDA, SOD in serum when dry weight was reached after dialysis. Results Before treatment, there was no intergroup statistical difference in depression score, concentration of IL-6, Hcy, MDA, SOD in serum( P > 0.05) between the two groups. After 6-month treatment, the depression score and the serum concentration of IL-6, Hcy, MDA in HFHD group decreased significantly( P<0.05), and the SOD concentration increased( P<0.05). There was no noticeable change of all the indicators of CHD group compared with those before treatment( P>0.05). The depression score and the level of serum IL-6, Hcy, MDA in group HFHD decreased compared with CHD group, and the SOD concentration increased as well( P<0.05). Analysis showed that there was a positive correlation between depression score and IL-6, Hcy, MDA level(r=0.367, 0.463,0.769, respectively). The correlation between depression score and SOD level was negative(r=-0.571). Conclusions HFHD can alleviate depression states by eliminating IL-6,Hcy,MDA more efficiently and increasing SOD level than CHD in MHD patients
Key words:  Depression  High-flux hemodialysis  Convention hemodialysis  Inflammatory factor  Oxidative stress

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