ABSTRACT
Objective To evaluate the effects of blood perfusion(HP)combined with hemodialysis(HD)on micro inflammation and malnutrition status in patients with maintenance of hemodialysis(MHD). Methods Eighty MHD patients admitted to blood purification center of Wuhan Puai Hospital in Hubei Province were enrolled and randomly divided into two groups. Pure HD group underwent conventional HD for 4 hours,3 times a week,and based on the weekly HD series,the HD+HP group took additionally HP once a week,the therapeutic course in both groups being consecutive 12 weeks. Blood was collected before and after treatment for detection of interleukin-6. (IL-6) and tumor necrosis factor-α(TNF-α) levels by enzyme-linked immunosorbent assay (ELISA), and the serum high sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) levels were determined with electrochemiluminescence immunoassay,and the changes in nutritional indexes of hemoglobin(Hb),total protein(TP), albumin(Alb),transferrin(TRF)were observed. Results Compared with the indexes before treatment,in HD+HP group,hs-CRP(ng/L:5.65±2.21 vs. 13.91±2.10),IL-6(ng/L:50.10±6.65 vs. 101.22±21.32),TNF-α(ng/L:80.21±9.41 vs. 197.64±25.47),Hcy(μmol/L:13.31±2.21 vs. 40.96±9.42)were significantly decreased (all P0.05). There were statistical significant differences in above indexes after treatment between HD+HP group and HD group〔hs-CRP (ng/L):5.65±2.21 vs. 13.22±1.10,IL-6(ng/L):50.10±6.65 vs. 100.32±25.24,TNF-α(ng/L):80.21±9.41 vs. 196.87±24.54,Hcy(μmol/L):13.31±2.21 vs. 37.23±8.33,Hb(g/L):106.65±22.21 vs. 94.22±13.10,TP (g/L):62.10±22.65 vs. 51.32±12.32,Alb(g/L):38.21±6.41 vs. 32.87±4.54,TRF(μg/L):196.31±22.21 vs. 162.23±15.33,all P<0.05〕. Conclusion HP combined with HD in the treatment of MHD can improve the micro inflammation and malnutrition state in patients with MHD.
ABSTRACT
Objective To investigate the effect of angiotensin Ⅱ (AngⅡ) type 1 receptor block irbesartan on the expression of renal cyclooxygenase-2 ( COX-2 ) in rats with type 2 diabetes mellitus.Methods 18 rats were divided into control group, diabetes mellitus group and treating group.Immunohistochemistry was used to measure the expression of COX-2, matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1).The urinary TXB2,6-Ket-PGF1 αconcentration was determined by radioimmunoassay at the 6th week .Results There was an increasing expression of COX-2,TIMP-1 and decreasing M MP-9 ( COX-2:0.39 ± 0.02 vs 0.24 ± 0.04, TIMP :0.41 ± 0.03 vs 0.24 ± 0.02,MMP-9:0.24 ± 0.02 vs 0.32 ± 0.02, P ＜ 0.05 ) expression in the diabetes mellitus group ( P ＜ 0.05 ).Irbesartan could increase MMP-9 (0.29 ± 0.03 ) and depress TIMP-1 (0.34 ± 0.02) expression through inhibiting the expression of COX-2(0.31 ± 0.03) in renal tissue.Conclusions COX-2 was involved in the pathogenesis of the injury of type 2 diabetic nephropathy.Irbesartan might exert its renoprotective effects through inhibiting COX-2 activity, modulating the expression of MMP-9 and TIMP-1.