慢性肾脏病非透析患者微炎症状态分析_临床医学论文.docVIP

慢性肾脏病非透析患者微炎症状态分析_临床医学论文 慢性肾脏病非透析患者微炎症状态分析_临床医学论文 作者：洪丽萍，周晓玲，陈孟华 【摘要】 　　目的 探讨慢性肾脏病(CKD)非透析患者微炎症状态标志物与肾功能及临床传统心血管病危险因素的关系。方法 选择CKD非透析患者100例,依据美国NKF-K/DOQI的肾功能分期标准，将患者分为CKD1期、CKD2期、CKD3期、CKD4期、CKD5期,每组20例。同期25例本院的健康体检者作为健康对照组。分别测定血清超敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、脂蛋白a（LPa）水平（均采用酶联免疫吸附法）及相关临床指标，比较不同CKD分期中血清hs-CRP、IL-6、LP（a）水平，并探讨炎症因子与肾功能及临床传统心血管病危险因素之间的关系。结果 ①CKD组患者的血清hs-CRP（3.54±2.57）mg·L－1 高于健康对照组（1.85±1.36）mg·L－1、IL-6（2.10±1.29）pg·mL－1高于对照组（1.53±0.93）pg·mL－1、LP（a）（326.34±124.39） mg·L－1高于对照组（152.32±63.46 ）mg·L－1，差异均有统计学意义(P＜0.05)。②与CKD l、2、3期患者比较，CKD 5期患者血清IL-6含量显著升高(P＜0.05)，CKD4、5期患者血清hs-CRP含量也显著升高(P＜0.05)；与CKD1、2期患者比较，CKD5期患者血清LP（a）含量显著升高(P＜0.05)。③相关分析显示，CKD患者血清hs-CRP与血肌酐呈正相关性（r=0.502，P＜0.01）；LP（a）水平与血肌酐呈正相关性（r=0.274，P＜0.05）。结论 CKD患者微炎症状态标志物hs-CRP、IL-6、LP（a）本身可能作为损伤因子，参与肾功能恶化，并可能与心血管病变的发生有关。微炎症因子在CKD患者中有早期预测心血管疾病（CVD）的重要作用，有望用于CKD患者并发心血管疾病的早期诊断、危险分层。 【关键词】 慢性肾脏病；微炎症；超敏C反应蛋白；白细胞介素-6；脂蛋白（a） 　　Abstract: Objective To investigate the serum level of interleukin-6 (IL-6), High sensitive C-reactive protein（hs-CRP）, lipoprotein(a) ［LP（a）］ in patients with chronic kidney disease（CKD） and to explore the relationship between micro-inflammation state and the risk factors of cardiovascular disease (CVD). Methods 100 patients with chronic kidney disease (CKD) were divide into 5 groups according to K/DOQI. 25 healthy persons were selected as the control group. Serum level of IL-6、hs-CRP and LP(a) were determined by ELISE assay. Some related clinical indicators were detected at the same time. The relationships between the serum IL-6、hs-CRP、LP(a)level and renal function and other clinical indicators were analyzed. Results Compared with control group, the serum level of hs-CRP（3.54±2.57）mg·L-1 vs (1.85±1.36)mg·L-1 IL-6（2.10±1.29）pg·mL-1 vs (1.53±0.93）pg·mL-1 and LP（a）（326.34±124.39 ）mg·L-1 vs (152.32±63.46）mg·L-1 were significantly higher in patients with CKD（P＜0.05）. In CKD group, the serum IL-6（3.18±1.03） pg·mL-1 level was significantly higher in patients with grade 5 renal function