慢性肾功能衰竭与慢性炎症反应状态关系的探讨  

Study on the Chronic Inflammatory Status in Patients with Chronic Renal Failure(CRF)

作　　者：邓利荣[1] 王彩丽[1] 魏红[1] 杨玉华[1] 

机构地区：[1]包头医学院第一附属医院肾内科,014010

出　　处：《放射免疫学杂志》2005年第6期451-454,共4页Journal of Radioimmanology

摘　　要：目的:探讨慢性肾功能不全与慢性炎症反应的关系。方法:126例肾功能不全患者,按分期分4组,每组每人分别测血肌酐(Scr)、肌酐清除率(Ccr)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)和肿瘤坏死因子(TNF-α);IL-6和TNF-α采用放射免疫分析,CRP和IL-10采用ELISA。结果:①慢性肾功能不全各期CRP、IL-6、IL-10、TNF-α水平与对照组比较均增高,P<0.001;②CRP、IL-6、IL-10及TNF-α与血肌酐呈正的直线相关关系,相关系数分别为0.716、0.836、0.501、0.574,与肌酐清除率呈负的直线相关关系,相关系数分别-0.755、-0.825、-0.497、-0.564;随着慢性肾功能不全(CRF)肾功能损害程度的加重,CRP、IL-6、IL-10、TNF-α值升高。③相关分析提示,急性时相蛋白CRP、炎性介质IL-6、TNF-α与抗炎介质IL-10均有相关性,相关系数分别为0.463、0.546、0.402。结论:①慢性肾功能不全患者急性时相蛋白CRP、致炎性介质IL-6、TNF-α及抗炎性介质IL-10水平增高;②随着肾功能损害程度的加重,急性时相蛋白CRP、致炎性介质IL-6、TNF-α及抗炎性介质IL-10水平增高;③急性时相蛋白CRP、致炎性介质IL-6、TNF-α与抗炎性介质IL-10有一定的相关性。Objective To study the relationship between the status of chronic inflammation and deterioration of renal function in patients with chronic renal failure （CRF）. Methods Serum CRP, IL- 10 （with ELISA）, TNF-α, IL-6 （with RIA） and creatinine （with bio- chemistry methods） levels were determined in 126 patients with CRF of various stages as well as in 30 controls. The creatinine clearance rate （CCr） was also calculated. Results ①In all these patients, the serum CRP, IL -6, IL-10 and TNF -α contents were significantly higher than those in the controls （P 〈 0.01 ）. ② CRP, IL - 6, IL - 10 and TNF - α levels were linearly positively correlated with the creatinine levels （r =0. 716,0. 836,0. 501 and 0. 574 respectively） , linearly negatively correlated with the creatinine clearance rate （r = - 0. 755, - 0. 825, - 0.497 and - 0. 564 respectively）. As the renal function deteriorated progressively, the serum levels of CRP, IL -6, IL- 10 and TNF-α increased correspondingly. ③The acute phase protein CRP and inflammatory cytokines IL -6 and TNF -α levels were correlated with those of the anti - inflammatory cytokine IL - 10 （r = 0. 463,0. 546 and 0.402 respectively）. Conclusion The serum acute phase protein CRP, inflammatory cytokines IL - 6, TNF - α and anti - inflammatory cytokine IL - 10 contents were all gradually increased alorg with the progression of CRF and these in flammatory mediators were mutually positively correlated with each other.

关 键 词：慢性肾功能不全 慢性炎症反应 C反应蛋白 白细胞介素-10 白细胞介素-6 肿瘤坏死因子 

分 类 号：R692.5[医药卫生—泌尿科学] R364.5[医药卫生—外科学]