Effects Of Different Blood Purification Methods On The Levels Of Myostatin And Inflammatory Mediators In Uremic Patients

Objective1.To investigate whether Hemodialysis+Hemoperfusion(HD+HP)can clear Myostatin(MSTN),Interleukin-6(IL-6)and Tumor Necrosis Factor-a(TNF-a)in uremia patients with undergoing maintenance hemodialysis(MHD);2.To investigate the effects of HD+HP and Hemodialysis(HD)on the clearance of MSTN,IL-6 and TNF-ain uremia patients with MHD;3.To investigate the effects of HD+HP and HD on the clearance of Hemoglobin(Hb),Albumin(Alb),Serum Creatinine(BUN)and Blood Urea Nitrogen(SCr)in uremia patients with MHD;MethodsAccording to the inclusion criteria and exclusion criteria,40 cases uremia patients who underwent maintenance hemodialysis in our blood purification center from October 2017 to May 2018 were chosed.All patients had stable conditions.According to different blood purification methods,they were randomly divided into 2 groups,20 cases in each group.Experimental Group took HP+HD treatment once a week and pure HD took place three times a week.Contral group took conventional HD 3 times per week.The therapeutic course in both groups were lasting for four weeks,and the whole dialysis dose was 12h/week.Both of them used bicarbonate dialysate.The dialysate flow rate was 500ml/min,the average blood flow was 250±20 ml/min,and the unfractionated heparin was anticoagulated.Serum MSTN,IL-6,TNF-a,Hb,Alb,SCr and BUN were measured prior to and following 4 weeks'treatment.After centrifugation using a centrifuge,the upper serum was taken out,dispensed it into an EP tube.and marked on those EP tubes,stored them in a-70? refrigerator.And serum MSTN,IL-6 and TNF-a levels were determined by ELISA.The levels of Hb,Alb,SCr and BUN were measured by Roche automatic biochemical analyzer.The changes of biochemical indexes were compared prior to and following treatment.The effects of different blood purification methods on the levels of MTSN,IL-6,TNF-a,Hb,Alb,SCr and BUN in uremic patients with MHD were compared.The data were expressed as means±standard deviation(x±s).Statistical analysis was performed with SPSS 22.0.The statistical significance of pre-and post-treatment differences was analyzed using paired t-tests.The comparison between groups was performed by independent sample t test.The count data was analyzed by x2 test.P<0.05 was considered to indicate a statistically significant differenceResults1.The general clinical data such as age,sex,and average dialysis age and the levels of Hb,Alb,SCr,BUN,MSTN,IL-6 and TNF-a before treatment were not statistically significant(P>0.05)2.The serum levels of MSTN,IL-6 and TNF-a in the experimental group were lower than those before treatment,and the difference was statistically significant(P<0.05).The serum levels of MSTN,IL-6 and TNF-a in the control group were slightly lower than those before treatment,but the difference was not statistically significant(P>0.05).3.There was no significant difference in serum Hb and Alb levels between the experimental group and the control group before the treatment,and the difference was not statistically significant(P>0.05).4.The serum levels of SCr and BUN in the experimental group and the control group were lower than those before treatment,and the difference was statistically significant(P<0.05).Conclusion1.HD+HP can reduce the levels of MSTN,IL-6 and TNF-a in patients with uremia MHD.2.HP combining with HD is an effective method for clearing MSTN,IL-6 and TNF-a in uremic patients,and the effect is better than HD.3.HD+HP and HD can effectively clear small molecules such as SCr and BUN in uremic patients,and do not reduce the levels of Hb and Alb.