终末期肾病患者开始透析时炎症状态及其相关因素分析  

The inflammation state of end-stage renal disease at the initiation of dialysis and the correlative factors

作　　者：田政湘[1] 肖海清[1] 何计南[1] 黄安兰[1] 

机构地区：[1]湖南师范大学第一附属医院肾内科,湖南长沙410005

出　　处：《西部医学》2010年第3期508-511,共4页Medical Journal of West China

摘　　要：目的探讨终末期肾病患者开始透析时炎症状态并分析其相关因素。方法通过查阅湖南长沙地区两大血透中心2004～2009年间开始第一次透析的所有133例终末期肾病患者的病案获得血清C-反应蛋白(CRP)值和其他人口统计学及实验室数据。将患者按不同标准分组并计算整个患者群的肾小球滤过率(GFR)及不同分组情况下的平均CRP浓度和其他指标,比较组间差异,分析各指标间可能存在的关系。结果所有被调查患者的平均CRP浓度为(7.09±6.92)mg/L;高血压肾病组平均CRP浓度高于慢性肾炎组(P<0.01);血清白蛋白与CRP呈负相关(P<0.05)。整体而言,血清CRP浓度和肾功能水平之间并无直线相关;当GFR<10.0 ml/(min.m2)时,GFR与CRP呈负直线相关。而当GFR>10.0 ml/(min.m2)时,两者之间无线性相关。结论炎症反应在我国慢性肾功能衰竭患者中普遍存在;随着肾功能水平的进一步下降,炎症反应逐渐加重,当GFR<10.0 ml/(min.m2)时,CRP随GFR下降而升高,两者呈线性负相关。要有效防治炎症,选择恰当的透析时机有可能改善患者的病情及预后。Objective To investigate the inflammation status of 133 ESRD patients at the initiation of dialysis and analyze the possible correlative factors. Methods Levels of serum C-reaction protein （CRP）, blood urea nitrogen （BUN） and serum creatinine （Scr） were obtained through reviewing the case records of 133 ESRD in-patients at their first dialysis treatment. The patients were divided into different groups by various standards. Means C-reactive protein （CRP）, glomerulus filtration rate（GFR） and other variables were calculated. Results The levels of CRP in all patients was（7.09±6.92）g/L. The means of CRP was significantly higher in hypertension than that in glumerular nephritis patients （P〈0.05）. The levels of serum-albumin{ALB）was negatively correlated with CRP. In general, there was no linear correla- tion between CRP and GFR. When GFR〈10ml/min, CRP was significantly correlated with GFR. Conclusion Inflammation status is very common in ESRD patients. As renal function decreases, inflammatory response gradually increased. CRP is negatively correlated with GFR only under certain conditions. Treatments of preventing inflammation effectively and selecting dialysis juncture appropriately are likely to improve patient＇s condition and prognosis.

关 键 词：血液透析 终末期肾病 C-反应蛋白 肾小球滤过率 

分 类 号：R459.5[医药卫生—治疗学]