血浆五聚素水平在慢性肾脏病患者的临床意义.docVIP

血浆五聚素水平在慢性肾脏病患者的临床意义 樊雨良 刘沁 陆遥 富秀英 陶晓阳 李花(上海市黄浦区中心医院肾内科 200002) 【摘要】目的：探讨慢性肾脏病(CKD)患者血浆五聚素3(PTX3)水平与肾小球滤 过率(GFR)、24小时尿蛋白定量的关系。方法：120例CKD患者分四组，每组 30例：①CKD3期组；②CKD4期组；③CKD5期非透析组；④CKD5期透析组, 另选健康对照组：健康正常人30人。患者均常规检测尿素氮、肌酹、24小时尿 蛋白定量等，用简化MDRD公式计算各组GFR,用放免法测定PTX3、超敏C反 应蛋白(hs?CRP)、肿瘤坏死因子(TNFa)o结果:1.PTX3、hs-CRP TNFa等炎症 介质在①组、②组、③组、④组均明显高于健康对照组；(Plt;0.05)o 2.随着GFR 的降低，PTX3水平逐渐升高：①组②组③④组(Plt;0.01)o 3. hs-CRP随着 GFR的降低，①组、②组、③④组呈逐渐上升趋势，但无统计学意义(P0.05)o 4. TNFa随着GFR的降低，①组、②组、③④组呈逐渐上升趋势，但①组、②组 无统计学意义(P0.05),而③④组〉①组(Plt;0.05),③④组②组(Plt;0.05), 有统计学意义。5. 24小时尿蛋白定量：③④组〉②组(Plt;0.05),②组〉①组 (Plt;0.05),均有统计学意义。6.CKD5期血液透析组与血透前、血透后PTX3 参数无明显变化(Pgt；0.05)无统计学意义。结论：CKD患者体内都存在炎症 状态，PTX3、hs-CRP、TNFa均高于健康人。与CRP相比，CKD患者的肾功能、 尿蛋白与PTX3关系更为密切。PTX3与CKD患者的GFR呈直线负相关，与24小 时尿蛋白定量呈直线正相关。 【关键词】慢性肾脏病 血浆五聚素3(PTX3)超敏C反应蛋白(hs-CRP) 肿 瘤坏死因子(TNFa) 24小时尿蛋白定量 血液透析 【中图分类号】R586 【文献标识码】A 【文章编号】2095-1752 (2013) 05-0117-03 [Abstract] Objective： To investigate the relations between plasma levels of Pentraxin 3 and glomerular filtration rate(GFR), 24-hour proteinuria in patients with chronic kidney disease. Methods： 120 patients with chronic kidney disease divided in to 4 groups, 30 patie nts per group: ① Stage 3 chronic kid ney disease； ② Stage 4 chronic kidney disease； ?Stage 5 chronic kidney disease without hemodialysis； ④ Stage 5 chronic kidney disease with hemodialysis； and 30 heathy in control group. Blood Urea Nitrogen, Serum Creatinine, 24-hour proteinuria were studied .GFR was calculated with simplified MDRD formula, Plasma Pentraxin 3(PTX3),high-sensitive C-reactive protein(hs-CRP) and Tumor necrosis factor-alpha(TNFa) were determined by RIA. Results : 1.Plasma PTX3^ hs-CRP、TNFa were at significantly higher levels in all four chronic kidney disease groups than those in control group(Plt;0.05). 2.PTX3 level rose with GFR level fallen: group①lt;group②lt;group③④(Plt;0.01). 3. hs-CRP levels of all four groups rose with GFR level fallen, had no statistic sign讦icance. 4.TNFa levels of all four groups rose with GFR lev