| Objective:To observe the effects of different blood purification methods on macrophage migration inhibitory factor(MIF)and related inflammatory factors in patients undergoing maintenance hemodialysis(MHD)treatment in the hemodialysis room of Chengde Central Hospital,and to explore the therapeutic effects of different blood purification methods on improving microinflammation state in hemodialysis patients.Methods:A total of 160 patients undergoing MHD treatment in the hemodialysis outpatient clinic of Chengde Central Hospital from September 2021 to September 2022 were randomly divided into hemodialysis group(HD),hemodialysis combined with hemodiafiltration group(HD+HDF),hemodialysis combined with hemoperfusion group(HD+HP),and hemodialysis combined with hemodiafiltration and hemoperfusion group(HD+HDF+HP).They received different blood purification methods for 6months.The following data were collected for each group:(1)Basic information of patients,including gender,age,primary disease,dialysis age,etc.(2)Fasting venous blood was drawn before different blood purification methods and tested for hemoglobin(Hb),serum creatinine(Scr),plasma albumin(ALB),phosphorus(P),calcium(Ca),intact parathyroid hormone(i PTH),etc.(3)Fasting venous blood collected before treatment,before single dialysis at 6 months of treatment and venous blood after dialysis.Serum MIF level was detected by enzyme-linked immunosorbent assay and interleukin-6(IL-6),C-reactive protein(CRP),procalcitonin(PCT),erythrocyte sedimentation rate(ESR)were also detected.The changes of basic data,MIF and IL-6,CRP,PCT,ESR and other related indicators before and after treatment for 6 months and before and after single treatment in MHD patients treated with different blood purification methods were compared.Paired samples t-test was used for self-comparison before and after;one-way ANOVA was used for intergroup comparison.Results:1.Inclusion of cases and comparison of baseline dataA total of 160 MHD patients were enrolled in this study.Eleven patients who did not meet the inclusion criteria were excluded.Finally,149 MHD patients were selected.Among the 149 MHD patients,the average age was(57.86±9.45)years old,ranging from 27 to 81 years old,and the dialysis age was(49.07±20.93)months.There were 79 males and 70 females.The patients were randomly divided into HD group(38 cases),HD+HDF group(36 cases),HD+HP group(38 cases),and HD+HDF+HP group(37 cases).The differences were not statistically significant(P>0.05)when comparing the baseline data such as gender,primary disease,age and dialysis age among the 4 groups;the differences were not statistically significant(P>0.05)when comparing Hb,ALB,Scr,Ca,P and i PTH before treatment among the groups.2.Comparison of MIF levels before and after treatment for 6 months and before and after single dialysis in each group of MHD patientsThere was no statistical difference in MIF levels before treatment among the groups(P>0.05).After six months of treatment,there was no statistical difference in MIF levels compared with before treatment in HD group(P>0.05);HD+HDF group decreased by an average of 6.21ng/m L(P<0.001);HD+HP group decreased by an average of 8.43ng/m L(P<0.001);HD+HDF+HP group decreased by an average of 6.22ng/m L(P<0.001);except for HD group,there was a significant difference in MIF levels after six months of treatment among the groups(P<0.001).Two-by-two comparison between groups showed that the mean value of HD+HP group was significantly lower than that of other three groups,and the difference was statistically significant(P<0.001).While there was no significant difference between HD+HDF group and HD+HDF+HP group(P>0.05).The change of MIF levels before and after single dialysis showed that MIF levels were significantly higher after blood purification treatment than before single dialysis in all groups(P<0.05).3.Comparison of CRP,PCT,IL-6,ESR levels before and at 6 months of treatment in each groupThere was no significant statistical difference in CRP,PCT,IL-6,ESR levels before treatment among the four groups(P>0.05);compared with before treatment,there was no significant difference in CRP,PCT,IL-6 and ESR levels after six months’ treatment in HD group(P>0.05);CRP,PCT,IL-6 and ESR levels were significantly lower than those before treatment(P<0.001)in HD+HDF group,HD+HP group and HD+HDF+HP group.After six months’ intergroup comparison,CRP,PCT,IL-6,and ESR levels were significantly lower than those in other three groups(P<0.001)in HD+HP group,while there was no significant difference between HD+HDF group and HD+HDF+HP group(P>0.05).Conclusions:1.The level of inflammatory factors is significantly increased in MHD patients,indicating that there is a micro-inflammatory state in the body,and that microinflammation state is related to blood purification therapy.2.The effect of removing MIF and other inflammatory factors by combining HP with HD is best.3.The effect on removing MIF and other inflammatory factors by combining HDF with HD is equivalent to that by combining HDF with HP.4.Simple HD therapy has no obvious effect on removing inflammatory factors in the body. |
