尿毒症非透析患者的微炎症状态及对脂蛋白(a)的影响  

Microinflammatory state in nondialysed patients with uremia and its influence on lipoprotein(a)

作　　者：杨海波[1] 谢恺庆[2] 张绍峰[3] 孙安远[2] 

机构地区：[1]广西医科大学微生物与免疫教研室,广西南宁530021 [2]广西医科大学第一附属医院血液净化中心,广西南宁530021 [3]广西医科大学第一附属医院检验科,广西南宁530021

出　　处：《临床荟萃》2005年第2期73-75,共3页Clinical Focus

基　　金：广西壮族自治区卫生厅医药卫生科研项目 (合同号 :Z2 0 0 30 1 4 )

摘　　要：目的　通过测定尿毒症非透析患者慢性炎症指标并分析其与脂蛋白 (a) [Lp(a) ]的关系 ,探讨非透析的尿毒症患者微炎症状态及其影响心血管系统的途径。方法　测定 5 5例尿毒症患者慢性炎症指标血C 反应蛋白(CRP)、白细胞介素 6 (IL 6 )、肿瘤坏死因子α(TNF α)及Lp(a) ,分析它们之间的关系 ,并与 30例正常人比较。结果　尿毒症组血CRP、IL 6、TNF α及Lp(a)分别为 (4 .0 6± 4 .0 2 )mg/L、(10 8.3± 88.3)ng/L、(1.4 1± 0 .5 3) μg/L和 (5 5 0± 4 31)mg/L ,均高于对照组 ,其中CRP、TNF α及Lp(a)与正常组比较差异有统计学意义 ;尿毒症患者血Lp(a)与CRP、TNF α、IL 6呈明显正相关 (r值分别为 0 .6 32、0 .4 2 5、0 .4 0 5 ,均P <0 .0 1)。结论　尿毒症患者存在微炎症状态 ;炎症可能通过引起Lp(a)代谢紊乱 。Objective To explore the microinflammatory state in nondialysed patients with uremia and the pathway that microinflammatory response effects on cardiovascular system by measuring chronic inflammatory indices and analyse its correlation with lipoprotein(a)[Lp(a)].Methods Serum chronic inflammatory indices including C-reactive protein(CRP),interleukin-6(IL-6) and tumor necrotic factor-α(TNF-α),as well as Lp(a) in 55 uremic patients,the relationship among them were analyzed.Results The serum CRP,IL-6,TNF-α and Lp(a) levels were ( 4.06± 4.02) mg/L,( 108.3± 88.3) ng/L, ( 1.41± 0.53) μg/L and (550±431) mg/L respectively in uremic group.All of them were higher in uremic group than those in the control,and the difference of CRP,TNF-α and Lp(a) levels between two groups had statistic significance.Lp(a) positively correlated with CRP,TNF-α and IL-6 respectively (r values were 0.632, 0.425, 0.405 respectively,each P value < 0.01).Conclusion There is microinflammatory state in nondialysed patients with uremia.Inflammation may have adverse reaction on cardiovascular system by leading to metabolic disorder of Lp(a).

关 键 词：尿毒症 微炎症状态 脂蛋白(a) 

分 类 号：R692.5[医药卫生—泌尿科学]