慢性肾功能衰竭患者超敏C反应蛋白水平的临床观察  

Level of high sensitive C-reactive protein in patients of chronic renal railure

作　　者：倪玲[1] 朱汉威[2] 李妙英[1] 

机构地区：[1]上海市市东医院肾内科,上海200438 [2]上海市交通大学附属新华医院肾内科,上海200092

出　　处：《临床荟萃》2007年第8期547-550,共4页Clinical Focus

摘　　要：目的探讨慢性肾功能衰竭（CRF）患者超敏C反应蛋白（hs—CRP）水平与肾功能、透析方式、营养状况及脂代谢之间的关系。方法收集新华医院住院患者280例，测定血尿素氮（BUN）、血肌酐（Scr）、前白蛋白（PA）、总蛋白（TP）、白蛋白（alb）、hs—CRP、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）、脂蛋白（a）[Lp（a）]、载脂蛋白A（ApoA）、载脂蛋白B（ApoB）、体质量（kg）和患者入院当天的24小时尿蛋白定量；根据肾小球滤过率（GFR）将上述患者分为对照组（GFR≥90ml／min）34例、肾功能不全组（GFR30～89ml／min）59例和肾功能衰竭组（GFR≤30ml／min）187例；同时根据透析方式将肾功能衰竭患者分为非透析组78例，血透组88例和腹透组21例；比较各组间各项指标的相互关系。结果hs—CRP与肾功能呈显著负相关（r=-0．44，P〈0．01），与Lp（a）呈正相关（r=0．35，P〈0．01）。腹透组的hs—CRP水平显著升高。在肾功能衰竭组中，hs—CRP与PA、alb呈负相关（分别为r=-0．34，P〈0．01；r=-0．37，P〈0．01），而对TG、HDL-C、LDL—C、ApoA和ApoB的影响不明显。结论CRF患者中存在hs—CRP水平升高的炎症反应；而炎症反应与CRF患者的腹膜透析方式、营养不良和高Lp（a）血症密切相关。Objective To study the relationships between inflammatory marker-high sensitive C-reactive protein （hs-CRP） and renal function,dialysis mode,nutrition state and dyslipidemia metabolism in chronic renal failure（CRF） patients. Methods A total of 280 patients in Xinhua Hospital were collected. Blood urea nitrogen（BUN）, serum creatinine（ Scr）, pre-albumin （ PA ）, total protein （ TP ）, albumin, hs-CRP, total cholesterol （ TC）, triglyceride （TG）, low density lipoprotein cholesterol （ LDL-C）, high density lipoprotein cholesterol （HDL-C）, apolipoprotein A （ ApoA）, apolipoprotein B（ApoB）,lipoprotein（a）[Lp（a）], body mass and amount of 24 hour proteinuria in the first entrance day of these patients were measured. According to glomerular filtration rate（GFR）,these patients were divided into three groups：normal group（GFR≥90 ml/min） with 34 patients, renal dysfunction group（GFR 30-89 ml/min） with 59 patients and renal failure group（GFR≤30 ml/min） with 187 patients,according to the dialysis mode,renal failure group was divided into non-dialysis group （ 78 patients）, hemo dialysis group （ 88 patients） and peritoneal dialysis group （ 21 patients）. Results A reverse correlation was observed between hs-CRP level and GFR（ r = -0.44, P〈0.01） while a direct correlation was observed between hs-CRP and Lp（a） （ r =0.35, P〈0.01）. The level of hs-CRP in peritoneal dialysis group was significantly higher than non-dialysis and hemodialysis group. In renal failure group, reverse correlations were observed between hs-CRP and PA （r =-0.34, P〈0.01） and alb （r = -0.37, P〈0.01）, respectively and there were no close relationships between hs-CRP and TG, HDL-C, LDL-C, ApoA and ApoB. Conclusion Inflammatory stage increased with hs-CRP in CRF patients. Peritoneal dialysis aggravated the inflammation while the inflammation aggravated the malnutrition and hyperlipoproteinmia in CRF.

关 键 词：肾功能衰竭 慢性 C反应蛋白 蛋白质类 

分 类 号：R692.5[医药卫生—泌尿科学]