炎症因子在长期腹膜透析患者营养评估中的意义  

Value of Inflammatory Mediators in Nutritional Assessment in Peritoneal Dialysis Patients

作　　者：邵蓉蓉[1] 涂文婷[1] 许菲菲[1] 

机构地区：[1]温州医学院附属第一医院肾内科,温州325000

出　　处：《中国中西医结合肾病杂志》2004年第7期395-397,共3页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：温州市科学技术委员会基金资助项目 (No .H2 0 0A0 10 )

摘　　要：目的 :探讨慢性肾衰竭 (CRF)腹膜透析患者血液中炎症因子IL - 6、TNF -α、CRP的水平及与营养不良的关系。方法 :采用主观综合性营养评估法和血浆白蛋白值结合人体测量对 4 1例患者进行综合性营养评估 ,并将患者分为营养良好组与营养不良组 ,检测两组腹膜透析患者血液的IL - 6、TNF -α、CRP水平 ,并分析它们之间关系。结果 :发现营养不良患者血液的IL - 6、CRP、TNF -α水平明显升高 (P <0 .0 1) ,营养不良患者的血浆白蛋白、前白蛋白、nPNA明显下降 (P <0 .0 1)。相关性检验发现IL - 6、CRP、TNF -α与血浆白蛋白明显负相关 ,P值分别为 0 .0 0 5、0 .0 0 0、0 .0 0 7,IL - 6、CRP与小腿围明显负相关 ,P值分别为 0 .0 4 8,0 .0 0 4。结论 :炎症因子IL - 6、TNF -α、CRP在腹膜透析营养不良患者明显升高 ,提示炎症因子可能是导致CRF腹膜透析患者营养不良的重要原因之一。Objective:To investigate the relationship between inflammatory mediators such as interleukin-6(IL-6), tumor necrosis factor-alpha(TNF-α) and C-reactive protein(CRP) and malnutrition in peritoneal dialysis patients. Methods:According to subjective global nutritional assessment, serum albumin and anthropometric measures, patients were assessed and classified into nourished group and malnourished group. Concentrations of IL-6, NF-α and CRP were measured and compared between nourished group and malnourished group.Results:Concentrations of IL-6, TNF-α and CRP were significantly elevated in malnourished group compared to the nourished group(TNF-α、IL-6 and CRP,P< 0.01). Serum albumin, prealbumin and nPNA were significantly lower in malnourished group than those in nourished group(P< 0.01). Serum albumin was negatively correlated with IL-6, TNF-α and CRP(albumin vs IL-6 P=0.005, albumin vs CRP,P=0.000, albumin vs TNF-α,P=0.007). Calf perimeter was negatively correlated with IL-6 and CRP(calf perimeter vs IL-6, P=0.048, calf perimeter vs CRP, P=0.004).Conclusion:Serum IL-6, TNF-α and CRP significantly increase in malnourished peritoneal dialysis patients, which may be one of the important causes of malnutrition in peritoneal dialysis patients.

关 键 词：炎症因子 腹膜透析 营养评估 TNF-α CRP IL-6 

分 类 号：R692.5[医药卫生—泌尿科学]