维持性血液透析患者C反应蛋白与骨代谢紊乱的相关性  

Association between C reactive protein and the dysregulation of bone and mineral metabolism in hemodialysis patients

作　　者：马立萍[1] 邸志鹏[1] 于文慧[2] 

机构地区：[1]中国石油天然气集团公司中心医院血液净化中心,河北廊坊065000 [2]天津医科大学第二医院血液净化中心,天津300211

出　　处：《中日友好医院学报》2011年第5期279-281,289,共4页Journal of China-Japan Friendship Hospital

摘　　要：目的:探讨维持性血液透析患者骨代谢紊乱和微炎症反应之间的关系。方法:检测血液透析患者血浆C反应蛋白、钙、磷和甲状旁腺激素及其他临床生化资料,并计算钙磷乘积,所得数据与美国肾脏病基金会维持性透析患者骨代谢和骨病控制指南比较,分析各检测指标间的相关性。结果:在钙、磷、钙磷乘积和甲状旁腺激素4项指标中,均符合指南者共21例(14.6%),与未符合指南组比较,其hs-CRP水平显著降低(P<0.05),高血压患者比例亦显著降低(P<0.05)。所有患者的C反应蛋白与钙、磷、钙磷乘积、年龄均显著正相关(r=0.134、0.132、0.125、0.317,均P<0.05),C反应蛋白与甲状旁腺激素之间的相关性不显著。多元线性回归分析显示,钙、磷、钙磷乘积是C反应蛋白的独立危险因素(β=0.189、0.113、0.048,均P<0.01)。结论:骨代谢控制良好的维持性血液透析患者微炎症水平较低,并且微炎症状态与骨代谢各指标之间显著正相关。Objective：To study the relationship between the disorder of bone metabolism and microinflammation in hemodialysis patients.Methods：Clinical biochemistry information of hemodialysis patients was collected,including plasma high sensitivity C reactive protein（hs-CRP）,calcium（Ca）,phosphorus（P）and intact parathyroid hormone（iPTH）and other biochemical data,and calculate the calcium phosphate product（Ca×P）.The data was compared with the recommended range in the guidelines for bone metabolism and disease in chronic kidney disease（K/DOQI）and the relationship between the data were analyzed.Results：In Ca,P,Ca×P and iPTH,a total of 21（14.6%）patients met the recommended range in the K/DOQI guidelines and they had a significantly lower level of hs-CRP（P0.05）.The hs-CRP level was directly related to Ca,P,Ca×P and age（r=0.134,0.132,0.125,0.317,all P0.05）.There was no correlation between hsCRP and iPTH.Multivariate regression analysis revealed that the independent associations of hs-CRP were with underlying Ca,P and Ca×P levels（β=0.189,0.113,0.048,all P0.01）.Conclusion：The hemodialysis patients whose bone metabolism are better controlled have a lower level of microinflammatory.There is an association between the dysregulation of bone and mineral metabolism and chronic inflammation in hemodialysis patients.

关 键 词：血液透析 微炎症状态 肾性骨病 钙磷代谢 C反应蛋白 

分 类 号：R692.5[医药卫生—泌尿科学]