血透患者血浆TAFI及CRP 相关性及临床意义.docVIP

血透患者血浆TAFI及CRP 相关性及临床意义[摘要] 目的 探讨维持性血透患者血浆TAFI与CRP相关性及临床意义。方法 测定70例维持性血透患者血浆TAFI水平，并与慢性肾衰组（未血透）及正常对照组比较。维持性血透患者血浆TAFI与C反应蛋白进行相关性分析。结果 维持性血透患者血浆TAFI水平显著高于慢性肾衰组及正常对照组，并与C反应蛋白水平成正相关。结论 维持性血透患者存在炎症、内皮功能损伤及纤溶抑制，可能与其心血管病变有关。 [关键词] 血透；凝血酶激活的纤溶抑制物；心血管病 [中图分类号] R459.5 [文献标识码] B [文章编号] 1673-9701（2011）20-152-02 Significance of the Correlation of Plasma Thrombin-Actiatable Fibrinolysis Inhibitor and CRP in Maintenance Hemodialysis DONG Shaoshao1ZHANG Shengze1YE Lingli2YANG Qunwei1ZHU Yuan1 1.Division of Nephrology，The Third People’s Hospital of Wenzhou，Wenzhou 325000，China；2.Department of Clinical Laboratory， The Third Peoples Hospital of Wenzhou， Wenzhou 325000，China [Abstract] Objective To study the significance of the correlation of plasma thrombin-actiatable fibrinolysis inhibitor（TAFI） and C-reactixe protein（CRP） in maintenance hemodialysis. Methods Plasma TAFI in 70 maintenance hemodialysis patients were measured and were compared with those in chronic renal failure group and normal control group. The correlation of TAFI and CRP in maintenance hemodialysis was analysised. Results The level of plasma TAFI in maintenance hemodialysis were significantly higher than those in chronic renal failure group and normal controls group，it related to the levels of CRP. Conclusion This study shows the association of inflammation and hypofibrinolysis with maintenance hemodialysis，which may be associated with cardiovascular disease. [Key words] Hemodialysis；TAFI；Cardiovascular disease 虽然血液透析技术的不断进步提高了慢性肾功能不全患者的生存率，但心血管病变（CVD）仍是其死亡的主要原因[1]。动脉粥样硬化（AS）是缺血性心脑血管疾病共同的病理生理基础。近年的研究表明，AS的发生、发展与炎症、凝血纤溶调节系统密切相关[2]。同时也有研究表明凝血酶激活的纤溶抑制物（thrombin-actiatable fibrinolysis inhibitor，TAFI）在AS发生、发展中起重要作用[3]。本研究通过测定2009年1月～2010年4月本院血透中心70例维持性血透患者血浆TAFI及其与C反应蛋白（CRP）相关性，并探讨其临床意义。 1资料与方法 1.1一般资料 ①血透组70例，男44例，女26例，年龄30～89岁，平均（66.0±10.5）岁，均为慢性肾脏病5期患者，排除了血液病及慢性肝病，原发病为慢性肾小球肾炎32例，高血压肾病20例，马兜铃酸肾病4例，糖尿病肾病10例，慢性肾盂肾炎1例，多囊肾3例，平均血透时间为（23.5±11.3）个月。采用碳酸氢钠透析液、聚砜膜中空纤维透析器，透析器、血管路、瘘管针均为首次使用，法安明