血液透析患者超敏C-反应蛋白水平与营养状况及心室结构的相关研究  

Serum high sensitive C-reactive protein level correlates with nutritional status and heart structure in hemodialysis patients.

作　　者：张冬[1] 陈香美[1] 申力军[1] 魏日胞[1] 张利[1] 谢院生[1] 刘述文[1] 

机构地区：[1]解放军总医院肾内科解放军肾脏病中心暨重点实验室,北京100853

出　　处：《中国血液净化》2005年第2期62-64,共3页Chinese Journal of Blood Purification

基　　金：国家自然科学基金创新群体项目 (30 12 10 0 5 )

摘　　要：目的　评价维持性血液透析 (MHD)患者超敏C -反应蛋白 (hs -CRP)水平与营养状况及心室结构改变之间的关系。方法　选择在我院血液透析中心治疗的MHD患者 72例 ,所有患者均稳定透析 3个月以上 ,以免疫透射比浊法测定其透析前空腹hs -CRP ,同时测定所有患者透析前血红蛋白 (Hb)、血清白蛋白 (Alb)、前白蛋白 (PA)、转铁蛋白 (TF)、甘油三酯 (TG)及总胆固醇 (T -Ch) ,透析后采血测定血浆尿素和下次透析前尿素 ,计算尿素清除指数 (Kt/V)、蛋白分解率 (nPCR)及体重指数 (BMI) ,并用二维彩色超声心动图测定心脏左心房前后径 (LAD)、左心室前后径 (LVD)、室间隔厚度 (IVST)、左心室后壁厚度 (LVPWT)。根据hs-CRP水平分为升高组 (hs -CRP≥ 3mg/L)及正常组 (hs-CRP <3mg/L) ,分别观察hs-CRP与血清营养指标及心室结构之间的关系。结果　升高组Hb、Alb、PA、TF均低于正常组 ,两组比较差异均有显著性 (P <0 .0 5 ) ,而升高组心室结构指标LAD、LVD、IVST、LVPWT ,均大于正常组 ,两组比较差异均有显著性 (P <0 .0 5 )。血hs-CRP水平与Hb、Alb、PA、TF呈显著负相关 ,与LAD、LVD、LVPWT呈正相关。结论　超敏C -反应蛋白作为慢性炎症反应状态最具代表性的标志之一 ,可以反映维持性血液透析患者的营养状况 ,并可以用来评?Objective To investigate serum high sensitive C-react ive protein(hs-CRP) level and its correlation with the nutritional status and th e heart structure in maintenance hemodialysis(MHD) patients. Methods This study included 72 MHD patients who were followed-up for more than 3 months in our dialysis center. The serum levels of hs-CRP, hemo globin, albumin, prealbumin, transferin, triglyceride, cholesterol were determin e d. The left atrial diameter and interventricular septum thickness, left ventricu lar posterior wall thickness were measured by echocardiography. These patients w ere divided into elevated hs-CRP group(hs-CRP≥3mg/L)and normal hs-CRP group(h s-CRP<3mg/L). The associations between hs-CRP and nutrition status and the hea rt structure were analyzed respectively. Results Hb, Alb, preAlb and TF concentration were significantly lower in elevated hs-CRP group. There were negative relationship between hs-CRP and Hb, Alb, preAlb, TF and positive relationship between hs-CRP and left ventri cular diameter and interventricular septum thickness, left ventricular posterior wall thickness respectively. Conclusion hs-CRP might be a marker for the nutrition status a nd ventricular hypertrophy.

关 键 词：超敏C-反应蛋白 血液透析 营养状况 

分 类 号：R446.6[医药卫生—诊断学]