动静脉瘘功能状态对C反应蛋白的影响及相关性的临床研究

目的主要探讨中年维持性血液透析(MHD)患者的动静脉瘘功能状态对超敏C反应蛋白(CRP)的影响,及其变化对营养状况和贫血的影响。方法收集50例中年MHD患者,血透6个月后,评估动静脉瘘功能,同时检测血透前及血透6个月时相关血液指标。结果①50例中年MHD患者,手术后动静脉瘘血流量在200～250mL/min之间;②与未血透时比较,血透后CRP显著降低(P<0.05),白蛋白、血红蛋白和红细胞计数显著升高(P<0.05);③6个月后,与动静脉瘘功能正常组(n=29,200～250mL/min)比较,动静脉瘘功能不良组(n=20,150～200mL/min),血透后CRP显著增高(P<0.05),白蛋白、血红蛋白和红细胞计数显著降低(P<0.05);④动静脉瘘功能与CRP水平呈负相关(r=-0.534,P<0.01);CRP与白蛋白、血红蛋白、红细胞呈负相关(r=-0.498,P<0.05)。结论监测、维持动静脉瘘良好的功能,对于MHD患者微炎症、营养状况和贫血的改善起着重要作用。

Clinical Study on the Impact of Functional Status of Arteriovenous Fistula on the C-reactive Protein and the Correlation

Objective To explore the influence of the functional status of arteriovenous fistula on the sensitivity C-reactive protein (CRP) in middle-aged patients with maintenance hemodialysis (MHD), and the impact of changes in nutritional status and anemia. Methods 50 middle-aged MHD patients with hemodialysis for 6 months received the assessment of the function of arteriovenous fistula, and the related serum levels before and six months after the hemodialysis were detected. Results ①The arteriovenous fistula’s blood flow was 200 ~ 250 mL/min after surgery; ②The CRP after hemodialysis was significantly lower, while the albumin, hemoglobin and red blood cell count was significantly higher compared with the CRP before hemodialysis (both P <0.05); ③The CRP in the arteriovenous fistula dysfunction group (n = 20, 150 ~ 200 mL/min) was significantly increased, while the albumin, hemoglobin and red blood cell count was significantly lower compared with the arteriovenous fistula normal group (n = 29, 200 ~250 mL/min) (both P <0.05); ④The function of arteriovenous fistula was negatively correlated with CRP level (r = -0.54, P <0.01); CRP was negatively correlated with albumin, hemoglobin and red blood cells (r = -0.498, P <0.05). Conclusions Monitoring and maintaining good function of arteriovenous fistula play an important role in improvement of micro-inflammation, nutritional status and anemia for patients with MHD.