维持性透析患者微炎症状态相关因素剖析.docVIP

维持性透析患者微炎症状态相关因素剖析 　　[摘要] 目的 通过测定维持性血液透析和腹膜透析患者的微炎症指标CRP，并分析其与血清白蛋白、血红蛋白、血肌酐及脂蛋白Lp（α）之间的关系。 方法 选择我院近年收治的尿毒症行血液透析患者30例和行腹膜透析患者20例，同时随机选取我院同期体检的健康者20例为对照组。检测C反应蛋白、血肌酐、血清白蛋白、血红蛋白、血清铁蛋白及脂蛋白等指标，分析比较各组间炎症指标。且比较两组各相关因素。 结果 HD、PD治疗组的CRP均高于对照组，差异有统计学意义（P 0.05），HD组C反应蛋白高于PD组（P 0.05）。两治疗组CRP水平与Lp（α）呈正相关，而与Scr、SF水平之间无相关性，同Hb、ALB水平之间的关系为负相关。 结论 慢性肾衰竭维持性透析患者的CRP水平显著高于正常人群，其水平与ALB、Lp（α）、Hb具有一定的相关性。微炎症反应在血液透析患者中比较严重，要高于腹膜透析患者。 　　[关键词] 维持性透析；微炎症；相关因素 　　[中图分类号] R459.5 [文献标识码] B [文章编号] 1673-9701（2012）03-0042-03 　　 　　Analysis of micro-inflammation state and its relative factors in maintenance dialysis patients 　　XU Junfu 　　Deptment of Nephrology，Ningbo NO.2 Hospital，Zhejiang Province，Ningbo 315000，China 　　[Abstract] Objective To analyze the level of C-reaction protein (CRP) as a index of micro-inflammation in maintenance hemodialysis patients and peritoneal dialysis patients, and to analyze its relationship with serum albumin, hemoglobin, serum creatinine and lipoprotein (α). Methods To explore the level of 30 hemodialysis patients, 20 peritioneal dialysis patients and 20 normal controls, plasma CRP, Scr, ALB, SF, Hb, Lp(α). To compare with the infectional indexes and the factors between hemodialysis patients and peritoneal dialysis patients. Results HD patients and PD patients infectional indexes were higher than normal controls, such as CRP (P 0.05). HD patients CRP were higher than PD patients CRP (P 0.05). CRP had not the correlation with Scr、SF, and had the positive correlation with Lp (α), and negative correlation with Hb，ALB. Conclusion Maintenance dialysis patients CRP are higher than normal controls, HD patient, infection is more serious than PDs, and infection is associated with ALB, Hb, and Lp(α). 　　[Key words] Maintenance dialysis; Microinfection; Relative factors 　　维持性透析治疗是终末期肾病的主要治疗方法。大量研究证明维持性透析患者中普遍存在微炎症状态，可以引起机体多方面的变化，例如生理、行为、生化、营养情况、炎性反应及CRP升高等[1]。而且造成肾损害严重，对其预后和临床并发症有严重影响，加重肾衰的进程，使患者病死率明显升高。血液透析、腹膜透析作为慢性肾功能衰竭患者的两种透析方法，本文拟从炎症反应的角度，对比两种透析模式，同时通过对透析患者各项生化