The Correlation Research On The Effect Of Different Immunomodulators From Patients With Maintenance Hemodialysis

Background and Objective:Chronic kidney disease(CKD)is a group of clinical syndromes with structural and functional impairment of chronic kidney caused by various causes.At present,CKD has become another major disease affecting human health after cardiovascular diseases,tumors and diabetes mellitus,and has become a global public health problem.Because CKD patients have no obvious clinical manifestations in the early stage,many patients have developed End-stage renal disease(ESRD)at the time of diagnosis.End-stage renal disease is the final stage of chronic kidney disease,the decline of renal function is irreversible,and about 90%of glomeruli have global sclerosis.Because the kidney can not produce urine normally,leading to more harmful substances in the body can not be collected and discharged from the body,so alternative therapy is the main treatment of ESRD.Because of the shortage of kidney source and the high cost of kidney transplantation,people mainly choose hemodialysis or peritoneal dialysis as an alternative treatment.Maintenance hemodialysis(MHD)is the main way of life extension for the majority of ESRD patients in China.However,the survival rate of hemodialysis patients with end-stage renal disease is still not optimistic,and the mortality rate is significantly higher than that of the general population.Studies over the past 30 years have found that infection plays an important role in the mortality of MHD patients,medical expenditure caused by infection has become an important part of the economic expenditure of MHD patients.Due to the influence of dialysis membrane,hemodialysis machine stimulation and bacteria and their own components in dialysis fluid during dialysis,MHD patients have immune dysfunction and are prone to infection.Various infectious complications caused by immune dysfunction have seriously affected the survival rate and quality of life of MHD patients.Therefore,improving the immune function of MHD patients and reducing the incidence of infection of MHD patients have become a widespread concern of scholars at home and abroad.Current studies have found that the use of some Chinese patent medicines and the increase of dialysis adequacy can improve the immune function of dialysis patients,but the application of immunomodulators in MHD patients is rare.This study focused on the effects of thymopentin and Bozhi glycopeptide on cellular immune function in maintenance hemodialysis patients,and confirmed the feasibility of using immunomodulators in MHD patients.To improve the immune dysfunction and microinflammation of MHD patients,reduce the incidence of infection,and provide clinical basis for improving the quality of life of MHD patients.Methods:1.According to the inclusion and exclusion criteria,60 patients with maintenance hemodialysis were selected from the outpatient department of Jinan Fifth People’s Hospital of Shandong Province from January to October 2016.They were randomly divided into three groups with 20 cases in each group.Group A:HD+placebo(2ml/time/week,im),group B:HD+thymopentin(10mg/time/week,im),group C:HD+Bozhi glycopeptide(2ml/time/week,im)2.The baseline data of three groups were evaluated,including age,sex,composition ratio,Hb,Scr,Bun,Alb and PTH3.The T lymphocyte subsets(CD4+,CD8+,CD4+/CD8+),IL-2,IL-10 and hsCRP levels were measured on the first day of the experiment and three months after the treatment.4.Follow-up analysis of the number of patients with upper respiratory tract infection and the number of days of medication treatment in the three groups after stopping medication for half a yearThe experimental results were tested by t test,with P<0.05 as the statistical significanceResults:1.There was no significant difference in baseline data(age,sex,composition ratio,Hb,Scr,Bun,Alb,PTH)among the three groups(P>0.05).On the first day of the experiment,there were no significant differences in T lymphocyte subsets,serum levels of IL-2,IL-10 and hsCRP among the three groups(P>0.05).2.Three months later,the proportion of CD4+and CD4+/CD8+in group B and C were higher than those in placebo group(group A),the level of serum IL-2 and IL-10 were higher,and the level of serum hypersensitive C-reactive protein was lower(P<0.05).3.Following up for half a year,the number of patients with upper respiratory infection and the course of medication in group B and C were lower than those in group A(P<0.05).Conclusion:Thymopentin and Bozhi glycopeptide can improve the proportion of T lymphocyte subsets in MHD patients,they can regulate cellular immunity.They can improve microinflammation in MHD patients and reduce the incidence of upper respiratory tract infections.