Effects Of Different Blood Purification Methods On Micro-inflammatory State Of Dialysis Patients

Objective Observe the three different dialysis modes of low-throughput hemodialysis(LFHD),high-throughput hemodialysis(HFHD),and hemodiafiltration(HDF).Serum interleukin 2(IL-2)and serum interleukin 6(IL-6),the effect of serum interleukin 37(IL-37),to provide a more reasonable and high-quality hemodialysis model for improving the microinflammatory state of patients.Methods Seventy-five patients with maintenance hemodialysis(MHD)with a dialysis time of more than 6 months in the hemodialysis center of Qingdao Central Hospital of Shandong Province were selected,including 20 cases in the low-throughput hemodialysis group(LFHD)and high-throughput hemodialysis group(HFHD)30 cases,25 cases in the hemodiafiltration group(HDF),20 cases in the healthy control group.The levels of serum interleukin 2,serum interleukin 6,and serum interleukin 37 were measured by enzyme-linked immunosorbent assay(ELISA)in the three groups of patients before and after the first dialysis and before dialysis 3 months after the dialysis treatment.Blood creatinine(Scr),blood urea nitrogen(BUN),hypersensitive C-reactive protein(hs-CRP),b2 microglobulin(b2-MG),parathyroid hormone before and after dialysis and 3 months after dialysis treatment(IPTH),simultaneous determination of serum interleukin 2,serum interleukin 6,serum interleukin 37,blood creatinine(Scr),blood urea nitrogen(BUN),hypersensitive C-reactive protein,b2 microglobulin,parathyroid gland Hormone(IPTH)level,as a healthy control group.Results 1.The serum IL-2,IL-6,IL-37,hs-CRP,b2-MG,IPTH,Scr,BUN of 75 MHD patients before treatment were significantly higher than that of the normal control group(P <0.05).2.For the low-pass group,Scr and BUN had different meanings after the first treatment and after 3 months of treatment for each index(P <0.05),and there was no difference in other indexes(P> 0.05).3.Compared with the pre-treatment,the Scr,BUN,b2-MG,and IPTH were different in the Qualcomm group after the first treatment and after 3 months of treatment(P <0.05),but there was no IL-6 after the first treatment Significance(P> 0.05),different significance after 3 months of treatment(P <0.05),no difference between the first treatment of hs-CRP,IL-2,IL37 and 3 months after treatment(P> 0.05).4.For HDF group,after the first treatment and after 3 months of treatment for each index,Scr,BUN,b2-MG,IPTH,IL-2,IL-6,IL37 have different meanings compared to before treatment(P < 0.05),no difference in significance after the first treatment of hs-CRP(P> 0.05),and difference in significance after 3 months of treatment(P <0.05).Conclusion 1.MHD patients have a micro-inflammatory state.2.Low-throughput hemodialysis has a good ability to remove small molecule toxins,but it has poor ability to remove medium-molecular toxins represented by b2-MG and IPTH.It has no significant removal effect on hs-CRP and three types of interleukins,which improves dialysis The patient's micro-inflammatory state has no obvious effect.3.High-throughput hemodialysis has a certain clearance ability for small and medium molecules,and has a certain clearance effect for interleukin 6 after 3 months of treatment.It has a certain improvement effect for improving the micro-inflammation of dialysis patients.-CRP,interleukin 2 and interleukin 37 have no obvious clearance effect.4.Hemodiafiltration has a clear effect on the inflammatory factors represented by hs-CRP and IL-6,has a clear effect on improving the micro-inflammatory state of dialysis patients,and is superior to low-throughput and high-throughput hemodialysis.After hemodiafiltration treatment,the levels of IL-2 and IL-37 decrease,and it is still not clear that it is caused by the body's response after hemodiafiltration clearance or micro-inflammatory improvement.