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Objective:To investigate the effect of hemodiafiltration combined with Jinshuibao tablet on serum inflammatory factors and oxidative stress indices in patients with diabetic nephropathy. Methods:A total of 86 patients with diabetic nephropathy who received treatment in The Second People's Hospital of Liaocheng from April 2019 to April 2020 were included in this study. They were randomly assigned to receive either hemodiafiltration (control group, n = 42) or hemodiafiltration combined with Jinshuibao tablet (observation group, n = 44). Microinflammatory state, oxidative stress index level, renal function and nutritional status were compared between the two groups. Results:Before treatment, serum interleukin-6, high-sensitivity C-reactive protein and tumor necrosis factor-α levels in the control group were (30.13 ± 3.25) ng/L, (9.43 ± 2.57) mg/L, (46.69 ± 3.54) ng/L respectively, and they were (30.16 ± 3.34) ng/L, (9.48 ± 2.65) mg/L, (46.73 ± 3.38) ng/L respectively in the observation group. There were no significant differences in these indices between the two groups (all P > 0.05). After treatment, serum interleukin-6, high-sensitivity C-reactive protein and tumor necrosis factor-α levels in the control group were (16.69 ± 2.73) ng/L, (8.12 ± 2.21) mg/L, (35.63 ± 2.75) ng/L, respectively, and they were (12.34 ± 2.52) ng/L, (6.47 ± 1.53) mg/L, (26.65 ± 2.13) ng/L, respectively in the observation group. After treatment, serum interleukin-6, high-sensitivity C-reactive protein and tumor necrosis factor-α levels in both groups were significantly lower than those before treatment (control group: t = 20.52, 2.50, 15.99; observation group: t = 27.60, 6.16, 32.57, all P < 0.05). After treatment, serum interleukin-6, high-sensitivity C-reactive protein and tumor necrosis factor-α levels were significantly lower than those in the control group ( t = 7.68, 4.04, 16.97, all P < 0.05). Before treatment, serum levels of malondialdehyde, superoxide dismutase, and glutathione peroxidase in the control group were (5.63 ± 1.36) nmol/L, (63.38 ± 7.56) mU/L, and (195.96 ± 26.36) IU/L, respectively, while those in the observation group were (5.68 ± 1.25) nmol/L, (63.25 ± 7.38) mU/L, and (195.83 ± 26.27) IU/L, respectively. There were no significant differences in these indices between the two groups (all P > 0.05). After treatment, serum levels of malondialdehyde, superoxide dismutase, and glutathione peroxidase in the control group were (4.83 ± 1.13) nmol/L, (83.46 ± 5.75) mU/L and (236.69 ± 18.75) IU/L respectively, while those in the observation group were (4.24 ± 0.86) nmol/L, (88.75 ± 5.47) mU/L and (258.76 ± 15.47) IU/L, respectively. After treatment, serum levels of malondialdehyde, superoxide dismutase, and glutathione peroxidase in each group were superior to those before treatment (control group: t = 2.93, 13.70, 8.16, P = 0.002, < 0.001, < 0.001; observation group: t = 6.15, 17.99, 13.37, all P < 0.001). After treatment, serum levels of malondialdehyde, superoxide dismutase, and glutathione peroxidase in the observation group were superior to those in the control group ( t = 2.73, 4.37, 5.96, P = 0.004, < 0.001, < 0.001). After treatment, blood urea nitrogen, serum creatinine and 24-hour urine protein in the observation group were significantly lower than those in the control group ( t = 7.85, 8.71, 2.06, P < 0.001, < 0.001, 0.021), and creatinine clearance rate in the observation group was significantly higher than that in the control group ( t = 3.01, P = 0.002). Total protein, prealbumin and albumin levels in the observation group were significantly higher than those in the control group ( t = 9.47, 12.13, 6.18, all P < 0.001). Conclusion:Hemodiafiltration combined with Jinshuibao tablet for the treatment of diabetic nephropathy has a positive effect on microinflammatory state and oxidative stress index level and improves patient's renal function and nutritional status.
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Objective To observe the influence of hemoperfusion(HP) on microinflammatory state and atherosclerosis in uremic patients .Methods Thirty‐six patients with uremia were randomly assigned into 2 groups ,18 cases in eath group .The hemo‐dialysis(HD) group took hemodialysis for 3 times per week ,4 h per time;the HP+ HD group took once HP per week on the basis of HD .The levels of C‐reactive protein(CRP) ,total cholesterol(TC) ,triglyceride(TG) ,urea nitrogen(BUN) and serum creatinine (Cr) were measured before therapy and in six months after therapy .The atherosclerotic plaque size was detected by ultrasound with fine resolution .Results The levels of CRP ,TG and TC after treatment in the HP+ HD group were significantly decreased com‐pared with those before treatment and the HD group (P0 .05) .Conclusion HP can alleviate the inflam‐matory reaction and decrease the atherosclerosis occurrence .
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Objective: To study the effects of levocarnitine on recombinant human erythropoietin (rhEPO) dose and microinflammatory state in maintenance hemodialysis patients. Methods: Totally 326 maintenance hemodialysis patients were randomly divided into 2 groups: the treatment group (n = 163) and the control group (n = 163). The age, gender, course of disease, and conventional treatments were similar in the 2 groups. To maintain the hemoglobin (HB) within 110-120 g/L and hematocrit (HCT) at 33%-35%, the treatment group was given levocarnitine and rhEPO, and the control group was given rhEPO only. The weekly dose of rhEPO (IU/kg) and the erythropoietin response index (ERI) were calculated and compared between the two groups 8 months later. Meanwhile, the serum high-sensitivity C-reactive protein (hs-CRP) was monitored in the 2 groups before and after 8 months. Results: The weekly dose of rhEPO required for the treatment group was significantly lower than that required for the control group ([106±20] IU/kg vs [141±23] IU/kg, P<0. 05); the treatment group also had significantly lower ERI compared with the control group ([0. 93±0. 11] IU · L · kg-1 · g-1 vs [1. 35±0. 29] IU · L · kg-1 · g-1, P<0. 05). Serum hs-CRP level in the treatment group was significantly decreased 8 months after treatment ([5. 21±3. 20] mg/L vs [10. 33±2. 54] mg/L,P<0. 05), and it was also significantly lower than that in the control group after the treatment ([5. 21±3. 20] mg/L vs [9. 93±2. 12] mg/L, P<0. 05). Serum hs-CRP levels were not changed significantly in the control group before and after the treatment. Conclusion: Levocarnitine can reduce the dose of rhEPO in MHD patients, which might be associated with improvements of the microinflammation and erythropoietin resistance in MHD patients.