Cov txiaj ntsig ntawm HDF Ntawm Kev Ua Haujlwm Ntawm Lub Plawv Hauv Cov Neeg Mob Dialysis

Qhov xwm txheej ntawm cov kab mob raum raum kawg hauv Suav teb yog nce xyoo los ntawm xyoo. Raws li qhov kawg ntawm lub Kaum Ob Hlis 2022, tus naj npawb ntawm cov neeg mob kho hemodialysis (MHD) hauv Suav teb tau txog 844,000. Kev sib sau ntawm uremic toxins yog ze ze rau kev tuag siab hauv cov neeg mob MHD. Nyob rau xyoo 2003, European Uremic Toxin Research Group (EUTox) tau muab faib ua uremic toxins rau hauv peb pawg raws li lawv lub cev thiab tshuaj lom neeg: dej-soluble me me molecule toxins, nruab nrab thiab loj molecule toxins, thiab protein-bound toxins. Lub tsub zuj zuj ntawm uremic toxins ua rau oxidative kev nyuaj siab, fibrosis, mitochondrial tsis ua hauj lwm, thiab cov ntaub so ntswg hypoxia, ua rau lub dysfunction ntawm ntau yam kabmob hauv lub cev.

Nyem rau Cistanche rau mob raum

Hauv xyoo tas los no, cov kev tshawb fawb tau ua pov thawj tias indoxyl sulfate tuaj yeem ua rau vascular endothelial tsis ua haujlwm, oxidative stress, inflammatory teb, calcification, thiab thrombosis, txhawb atherosclerosis, thiab ua rau cov hlab plawv hauv cov neeg mob uremic. Kev sib sau ntawm cov tshuaj parathyroid hauv tag nrho cov ntu tuaj yeem ua rau muaj kab mob raum pob txha, hloov pob txha txawv txav, mineralization lossis lub zog, calcification ntawm cov hlab ntsha thiab cov nqaij mos, thiab thaum kawg kev loj hlob mus rau osteoporosis, pob txha, thiab vascular calcification. 2-MG tsub kom tsis tau tsuas yog ua rau kev lim ntshav amyloidosis nkaus xwb tab sis kuj muaj feem cuam tshuam ncaj qha rau cov neeg mob tuag ntau ntxiv.

Hemodialysis (HD) siv lub hauv paus ntsiab lus ntawm diffusion los pauv cov tshuaj thiab tsuas tuaj yeem tshem tawm cov co toxins nrog lub cev hnyav dua 5000 Da. Nyob rau hauv lub hauv paus ntawm HD, online hemodiafiltration (HDF) kuj muaj convection yam ntxwv, ua kom tiav parathyroid muaj nuj nqi. Kev tshem tawm tau zoo ntawm qhov nruab nrab thiab loj molecular co toxins xws li cov tshuaj hormones thiab 2-MG muaj qee yam zoo hauv kev txo qhov tshwm sim ntawm cov teeb meem plawv. DOPPS txoj kev tshawb fawb piv qhov kev pheej hmoo ntawm kev tuag hauv cov neeg mob lim ntshav tom qab HDF thiab HD kev kho mob thiab pom tias cov txheeb ze ntawm kev pheej hmoo ntawm kev tuag hauv pab pawg kho mob HDF tau txo qis los ntawm 35%.

The CONTRAST study found that HDF can better clear β2-MG, but the overall survival rate and cardiovascular survival rate are no different from low-flux HD; the ESHOL study showed that compared with receiving high-flux HD treatment, patients who received convection flow were 22.9 to Patients treated with 23.9 L of HDF had a 30% reduction in the risk of all-cause death and cardiovascular death. Turkish research found that compared with HD treatment, patients receiving HDF treatment with larger convection flow (>17.4 L / sijhawm) muaj 46% txo qis ntawm tag nrho cov neeg tuag thiab 71% txo qis hauv plawv plawv.

Lub 60th Lub Rooj Sib Tham Txhua Xyoo ntawm European Renal Association (ERA) hauv 2023 tau tshaj tawm cov txiaj ntsig kho mob tshiab kawg ntawm CONVINCE txoj kev tshawb fawb. Cov neeg mob uas muaj kab mob raum kawg uas tau txais kev kho HDF tau txais txiaj ntsig zoo. Piv nrog rau kev kho HD, kev tuag ntawm cov neeg mob kho HDF tau txo los ntawm 23%. %, thiab dhau qhov kev soj ntsuam nruab nrab ntawm 30 lub hlis, tag nrho-ua rau kev tuag yog 21.9% hauv cov neeg mob kho HD thiab 17.3% hauv cov neeg mob kho HDF.

Tam sim no tsis muaj cov ntaub ntawv tshawb fawb soj ntsuam zoo uas qhov kev kho HDF zaus tuaj yeem ua tiav cov txiaj ntsig zoo tshaj plaws. Peb tau tshawb fawb txog qhov cuam tshuam ntawm HDF ntau zaus ua ke nrog HD kev kho mob ntawm cov teeb meem luv luv, lub neej zoo, thiab kev kuaj mob hauv cov neeg mob uremia. Cov txiaj ntsig tau pom tias kev kho HDF tuaj yeem ua rau tus neeg mob nce qib albumin hauv cov ntshav thiab txo cov koob tshuaj erythropoietin thiab cov hlau tso rau hauv cov hlab ntsha; tus naj npawb ntawm kev mus pw hauv tsev kho mob thiab qhov ntev ntawm lub sijhawm rov qab los rau cov neeg mob kho HDF tau qis dua li ntawm ob qho kev kho ntshav purification cov neeg mob; ntawm cov neeg mob uas tsis tau txais kev lim ntshav tshiab, qhov ciaj sia taus ntawm cov neeg mob hauv pawg HDF tau nce siab dua li ntawm cov neeg mob nrog ob txoj kev kho ntshav kom huv; rau cov neeg mob lim ntshav tshiab tshiab, kev kho HDF, tshwj xeeb tshaj yog HDF ib zaug ib lub lim tiam, tus neeg mob lub neej tau zoo dua qub dua piv nrog ua ntej kho.

Kab mob plawv yog qhov teeb meem loj tshaj plaws thiab muaj teeb meem loj hauv cov neeg mob MHD, thiab cov hlab plawv tuag yog thawj qhov ua rau tuag hauv cov neeg mob MHD, nrog rau lub plawv tsis ua hauj lwm thiab kab mob plawv yog qhov ua rau tuag. Cov pov thawj uas twb muaj lawm qhia tau hais tias kev kho mob HDF high-convection tuaj yeem txo qis kev mob plawv hauv cov neeg mob MHD. Muaj qee qhov kev tshawb fawb txog qhov cuam tshuam ntawm HDF kev kho mob zaus ntawm kev ua haujlwm plawv. Tsis muaj cov ntaub ntawv hais txog kev sib raug zoo ntawm kev kho ntau zaus thiab kab mob plawv hauv Suav MHD cov neeg mob. Ob-dimensional speckle tracking echocardiography (2D-STE) taug qab lub spatial txav ntawm ncha me ntsis nyob rau hauv myocardium, ntsuas lub myocardial longitudinal strain Performance index thaum lub sij hawm systole, thiab kev ntsuam xyuas tag nrho thiab lub zos systolic kev hloov pauv ntawm sab laug ventricle los xyuas txog myocardial longitudinal strain index. thiab txhim kho cov ntshav txaus rau myocardium. Kev ntsuas qhov xwm txheej muaj qhov tseem ceeb hauv kev kho mob.

Peb siv 2D-STE, lub tshuab ultrasound tshiab, los ntsuas qhov cuam tshuam ntawm ntau zaus ntawm kev kho HDF ntawm kev ua haujlwm plawv hauv cov neeg mob MHD. Nws tau pom tias piv nrog HDF ib hlis ib zaug, kev kho HDF peb zaug hauv ib lub lis piam tuaj yeem txhim kho tag nrho sab laug ventricular strain ntawm MHD cov neeg mob nyob rau lub sijhawm luv luv, txo qis myocardial kev puas tsuaj, thiab tiv thaiv kev ua haujlwm ntawm lub plawv; 2D-STE tuaj yeem kuaj xyuas sab laug ventricular contraction hauv MHD cov neeg mob ua ntej. Kev ua haujlwm tsis zoo, thiab ua ntej qhov kev hloov pauv ntawm sab laug ventricular muaj nuj nqi qhia los ntawm LVEF. Kev kho HDF peb zaug hauv ib lub lis piam tuaj yeem pom zoo dua 2-MG, txhim kho kev lim ntshav txaus, txhim kho cov khoom noj khoom haus zoo dua thiab kev ua haujlwm ntawm lub plawv ntawm MHD cov neeg mob, thiab txhim kho tus neeg mob qhov kev mob tshwm sim.

Cistanche kho mob raum li cas?

Cistancheyog ib hom tshuaj suav tshuaj ntsuab siv rau ntau pua xyoo los kho ntau yam mob, suav nrograumkab mob. Nws yog muab los ntawm qhuav stems ntawmCistanchedeserticola, ib tsob nroj nyob rau hauv cov suab puam ntawm Tuam Tshoj thiab Mongolia. Lub ntsiab active Cheebtsam ntawm cistanche yogphenylethanoidglycosides, echinacoside cov tshuaj, thiabacteoside, uas tau pom tias muaj txiaj ntsig zoo rau lub raum kev noj qab haus huv.

Kab mob raum, tseem hu ua kab mob raum, hais txog ib yam mob uas lub raum ua haujlwm tsis zoo. Qhov no tuaj yeem ua rau muaj cov khoom pov tseg thiab cov co toxins hauv lub cev, ua rau muaj ntau yam tsos mob thiab teeb meem. Cistanche tuaj yeem pab kho mob raum ase los ntawm ntau lub tshuab.

Ua ntej, cistanche tau pom tias muaj cov nyhuv diuretic, txhais tau tias nws tuaj yeem ua rau cov zis ntau ntxiv thiab pab tshem tawm cov khoom pov tseg ntawm lub cev. Qhov no tuaj yeem pab txo lub nra ntawm lub raum thiab tiv thaiv kev tsim cov co toxins. Los ntawm kev txhawb nqa diuresis, cistanche kuj tseem tuaj yeem pab txo qis ntshav siab, ib qho teeb meem ntawm cov kab mob raum.

Ntxiv mus, cistanche tau pom tias muaj cov teebmeem antioxidant. Kev ntxhov siab oxidative, tshwm sim los ntawm qhov tsis sib xws ntawm kev tsim cov dawb radicals thiab lub cev tiv thaiv antioxidant, ua lub luag haujlwm tseem ceeb hauv kev mob raum. ies pab neutralize dawb radicals thiab txo Oxidative kev nyuaj siab, yog li tiv thaiv lub raum los ntawm kev puas tsuaj. Cov phenylethanoid glycosides pom hauv cistanche tau tshwj xeeb hauv kev tshem tawm cov dawb radicals thiab inhibiting lipid peroxidation.

Tsis tas li ntawd, cistanche tau pom tias muaj cov nyhuv anti-inflammatory. Kev mob yog lwm yam tseem ceeb hauv kev loj hlob thiab kev loj hlob ntawm cov kab mob raum. Cistanche's anti-inflammatory zog pab txo cov zus tau tej cov pro-inflammatory cytokines thiab inhibit qhov ua kom o yuav tsum tau txoj kev, yog li alleviating o nyob rau hauv lub raum.

Tsis tas li ntawd, cistanche tau pom tias muaj cov teebmeem immunomodulatory. Hauv kab mob raum, lub cev tiv thaiv kab mob tuaj yeem ua rau tsis zoo, ua rau muaj kev mob ntau dhau thiab cov ntaub so ntswg puas. Cistanche pab tswj lub cev tiv thaiv kab mob los ntawm kev hloov kho kev tsim khoom thiab kev ua haujlwm ntawm lub cev tiv thaiv kab mob, xws li T hlwb thiab macrophages. Txoj cai tiv thaiv kab mob no pab txo qhov mob thiab tiv thaiv kev puas tsuaj ntxiv rau lub raum.

Ntxiv mus, cistanche tau pom los txhim kho lub raum kev ua haujlwm los ntawm kev txhawb nqa kev tsim kho ntawm lub raum hlab nrog cov hlwb. Lub raum tubular epithelial hlwb ua lub luag haujlwm tseem ceeb hauv kev pom thiab rov nqus cov khoom pov tseg thiab electrolytes. Hauv kab mob raum, cov hlwb no tuaj yeem raug puas tsuaj, ua rau lub raum ua haujlwm puas. Cistanche lub peev xwm los txhawb kev tsim kho ntawm cov hlwb no pab kho lub raum kom zoo thiab txhim kho lub raum tag nrho.

Ntxiv nrog rau cov kev cuam tshuam ncaj qha rau lub raum, cistanche tau pom tias muaj txiaj ntsig zoo rau lwm yam kabmob thiab lub cev hauv lub cev. Txoj hauv kev zoo rau kev noj qab haus huv no tseem ceeb tshwj xeeb hauv cov kab mob raum, vim tias tus mob feem ntau cuam tshuam rau ntau lub cev thiab lub cev. che tau pom tias muaj kev tiv thaiv rau lub siab, lub plawv, thiab cov hlab ntsha, uas feem ntau cuam tshuam los ntawm kab mob raum. Los ntawm kev txhawb nqa kev noj qab haus huv ntawm cov kabmob no, cistanche pab txhim kho lub raum tag nrho thiab tiv thaiv kev mob ntxiv.

Hauv kev xaus, cistanche yog cov tshuaj suav tshuaj ntsuab siv rau ntau pua xyoo los kho mob raum. Nws cov active Cheebtsam muaj diuretic, antioxidant, anti-inflammatory, immunomodulatory, thiab regenerative teebmeem, uas pab txhim kho lub raum ua haujlwm thiab tiv thaiv ob lub raum los ntawm kev puas tsuaj ntxiv. , cistanche muaj txiaj ntsig zoo rau lwm yam kabmob thiab lub cev, ua rau nws txoj hauv kev zoo rau kev kho mob raum.