中文摘要：

目的：探讨血液透析滤过（HDF）对维持性血液透析（MHD）患者红细胞生成素（EPO）敏感性的影响及其可能的机制.方法：44例MHD患者随机分为高通量血液透析滤过组（HDF组）和常规低通量血液透析组（HD组）,干预12周,测定干预前、后高敏C反应蛋白（hs-CRP）、肿瘤坏死因子α（TNF-d）、白介素-6（IL-6）、血清白蛋白（ALB）、前白蛋白（preALB）、全段甲状旁腺激素（iPTH）、总胆固醇（TC）水平,并计算红细胞生成素抵抗指数（ERI）和营养不良-炎症评分（MIS）;结果：HDF组ERI、MIS、hs-CRP、TNF-α、IL-6、iPTH均降低,TC升高,与HD组比较均具显著差异（P＜0.05）;逐步回归分析提示对ERI的影响有统计学意义的变量,依次为MIS、IL-6、hs-CRP、iPTH、ALB（P＜0.05）.结论：HDF可显著降低MHD患者体内炎性因子水平、减轻微炎症状态、改善营养状况,降低ERI水平,增加EPO的敏感性.

英文摘要：

Objective ： To investigate the influence of hemodiafihration （HDF） on the responsiveness to erythropoi- etin （EPO） in patients on maintenance hemodialysis （MHD） and its mechanism. Methods： A total of 44 patients on MHD were randomly divided into HDF group and HD group, and were given HDF or HD therapy respectively for 12 weeks. The high sensitivity C-reactive protein （hs-CRP） , tumor necrosis factor-α （TNF-α） , interleukin-6 （IL-6）, serum albumin （ALB） , prealbumin （preALB） , intact parathyroid hormone （iPTH） , total cholesterol （TC） were detected before and after treatment. The erythropoietin resistance index （ ERI ） and malnutrition-inflammation score （MIS） were calculated. Results： The levels of ERI, MIS, hs-CRP, TNF-α, IL-6 and iPTH decreased significantly in HDF group, but the level of TC increased markedly. All above parameters showed significant difference as compared with those in HD group （P 〈 0.05 ）. In backward stepwise regression analysis, ERI was associated with MIS, IL-6, hs-CRP, iFFH and ALB. MIS was the biggest impact factor, followed by IL-6, hs-CRP, iPTH and ALB （P 〈 0.05）. Conclusion ： HDF could decrease the level of proinflammatory cytokines, alleviate microinflammatory state and improve nutritional status, then decrease ERI and improve the responsiveness to erythropoietin in MHD patients.