hsCRP、sEPCR与动静脉内瘘血栓形成的关系  

Relationship Between the Levels of hsCRP and sEPCR with Arteriovenous Fistulas Thrombosis

作　　者：陈彤[1] 范玉平[1] 陈宇翔[1] 吴俊渊[1] 张秀琳[1] 杨屹[2] 

机构地区：[1]南通大学第二附属医院检验科,江苏南通226001 [2]南通大学杏林学院,江苏南通226007

出　　处：《标记免疫分析与临床》2015年第4期294-297,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：目的观察高敏C反应蛋白(hs CRP)和可溶性内皮细胞蛋白C受体(s EPCR)在血液透析自体动静脉内瘘(AVF)血栓形成过程中的变化,探讨微炎症状态在AVF血栓形成过程中的作用。方法慢性肾功能衰竭(CRF)AVF术后患者152例按照是否出现内瘘血栓分为:内瘘通畅组(通畅组,n=120)和内瘘血栓组(血栓组,n=32);分别比较上述组间患者炎症状态相关的指标hs CRP与s EPCR。结果与通畅组比较,血栓组首次透析前,hs CRP、s EPCR水平与通畅组比较差异无统计学意义(P>0.05);hs CRP、s EPCR的含量在首次透析后均升高,hs CRP差异有统计学意义(P<0.05)。另外,血栓组透析后hs CRP水平明显高于透析前(t=2.79,P=0.01;t=2.59,P=0.01;t=2.72,P=0.01)。诊断性能分析提示,二者有相似的诊断性能,但hs CRP敏感性较好,而s EPCR特异性更佳。结论内瘘血栓形成时炎症指标升高,提示AVF血栓形成有炎症参与,炎症状态可能是AVF血栓形成的诱发因素。Objective To investigate the changes of high-sensitivity C-reactive protein （hsCRP）and soluble endothelial cell protein C receptor（sEPCR） in Chronic Renal Failure （CRF）patients with native arteriovenous fistulas （AVF） thrombosis, and to explore the relationship between inflammation and AVF thrombosis. Methods One hundred sixty-seven CRF patients with AVF were divided into two groups according to whether with thrombosis： unobstructed group （ n = 120） and thrombosis group n = 32）. The serum levels of hsCRP and sEPCR in two groups were detected and the results were analyzed. Results Compared with unobstructed group, the levels of hsCRP and sEPCR in thrombosis group were not significantly increased before the first dialysis （P 〉 0.05 ） ; the levels of hsCRP and sEPCR in thrombosis group were higher than that of in unobstructed group after the first dialysis, there were significant difference in hsCRP levels （ P 〈 0.05 ）. On the other hand, the hsCRP levels post-dialysis were higher than before dialysis（t =2. 79,P =0. 01 ;t =2. 59,P =0. 01 ;t =2. 72, P = 0.01 ）. Diagnostic efficiency analysis indicated that hsCRP and sEPCR had similar diagnostic performance, but the sensitivity of hsCRP was higher, and the sEPCR had better specificity. Conclusion The elevated inflammatory markers in AVF thrombosis indicate an inflammatory state participate in the process of AVF thrombosis. Inflammatory state may be a predisposing factor of AVF thrombosis, furthermore, which also may be an active participant.

关 键 词：炎症 自体动静脉内瘘 血栓形成 

分 类 号：R459.5[医药卫生—治疗学]