血液透析对慢性肾脏病凝血及炎症的影响  

Effects of hemodialysis on inflammation and coagulation changes in patients with chronic kidney disease

作　　者：王玉洁[1] 胡承刚[2] 彭素英 曹灵[1] 

机构地区：[1]泸州医学院附属医院肾病内科,四川646000 [2]泸州医学院附属中医院急诊科,四川646699 [3]涪陵中心医院肾病内科,重庆408000

出　　处：《中国临床新医学》2016年第3期210-213,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的探讨慢性肾脏病（CKD）5期患者透析与非透析炎症、凝血和纤溶指标的变化,分析血液透析对凝血及炎症的影响。方法选取2013-01～2014-12泸州医学院附属医院肾脏内科收治的93例CKD患者并检测相关凝血及炎症指标。结果与正常对照组35例相比,CKD5期患者57例凝血功能及炎症反应均随着肾小球滤过的下降而逐渐加重,差异有统计学意义。CKD5期透析组40例与非透析组17例相比,血清纤维蛋白原（Fg）有所升高,C反应蛋白（CRP）有所下降,差异有统计学意义（P〈0.05）;行直线相关分析CRP与Fg、D-D显著相关,呈正相关。结论 CKD5期患者可能存在高凝且继发纤溶亢进的状态,血液透析可能加剧这种紊乱,CKD5期患者高凝状态与炎症密切相关,CRP可能是其危险因素。Objective To study the effects of hemodialysis on the inflammation and coagulation change in the CKD5 patients. Methods The CKD5 patients were chosen in the~ Affiliated Hospital of Luzhou Medical College from January 2013 to December 2014 and their coagulation and inflammatory markers were detected. Results Com- pared with those in the control group （n = 35 ）, CKD5 of blood coagulation and inflammation in the CKD5 group（ n = 57） were significantly increased gradually with the decline in glomemlar filtration. Fg was significantly increased and CRP significantly decreased in the dialysis CKD5 group （n = 40） than those in the non-dialysis group （n = 17 ） （P 〈 0. 05）. Univariate correlation analysis showed that CRP was significantly positively correlated with Fg and D-D, Con- clusion CKD5 patients may have a hypercoagulable state and secondary fibrinolysis. Hemodialysis may aggravate these disorders. The hypercoagnlable state in CKD5 patients is closely related to inflammation and CRP may be the risk factor.

关 键 词：慢性肾脏病 血液透析 高凝 炎症 

分 类 号：R692[医药卫生—泌尿科学]