ESRD非透析患者血清TNF-α水平与其慢性并发症的关系

目的探讨非透析终末期肾病（ESRD）患者外周血清TNF—α与血红蛋白、红细胞压积、血压、血清甘油三酯、胆固醇、脂蛋白（a）、高密度脂蛋白、低密度脂蛋白及血清白蛋白水平相关性及其与非透析终末期肾病（ESRD）患者贫血、动脉粥样硬化、营养不良等慢性并发症的关系。方法采用ELISA检测65例ESRD非透析患者血清TNF—α水平，并以30例健康人为对照。同时测定ESRD非透析患者血红蛋白、红细胞压积、血清甘油三酯、胆固醇、脂蛋白（a）、高密度脂蛋白、低密度脂蛋白及血清白蛋白等水平。结果ESRD非透析患者血清TNF—α水平较正常人明显升高，并与血红蛋白、红细胞压积呈明显负相关，相关系数r和P值分别为：r=-0．526，P〈0．05，r=-0．20，P〈0．05；与脂蛋白（a）呈正相关，r=0．577，P〈0．05；与HDL—CH呈负相关，r=-0．529，P〈0.05；与血清白蛋白水平呈负相关，相关系数r和P值分别为：r=-0．526，P〈0．05。结论ESRD非透析患者外周血高水平TNF—α与其慢性并发症（贫血、动脉粥样硬化及营养不良）发生、发展有关。

Relationship between serum TNF-α level and chronic complications in non-dialysed end-stage renal disease patients

Objective To investigate the serum levels of necrosis factor alpha（TNF-α） and Hb, Hct, La（a）, LDL, Alb in non-dialyzed end-stage renal disease （ESRD） patients, and their relations to chronic complication （anemia, atherosclerotic cardiovascular and malnutrition morbidity）. Methods Sixty-five non-dlalyzed ESRD patients and 30 normal control subjects were enrolled. Serum level of TNF-α were measured by enzyme linked immunosorbent assay, and hemoglobin, hematocrit, cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, lipoprotein（a）, and albumin were measured. Results Serum TNF-α level in non-dialyzed ESRD patients was significantly higher than that of the controls. There was a significantly negative correlation between serum TNF-α level and Hb, Hct, HDL-CH and Alb in these ESRD patients （r=-0. 526,P〈0.05; r=-0. 520, P〈0. 05; r=-0. 529, P〈0. 05; r= -0. 526,P〈0.05）. Serum TNF-α level was significantly positively correlated with Lp（a） （r= 0. 577, P 〈 0. 05）. Conclusion Elevated levels of TNF-α maybe associate with an increased chronic complication （anemia, atherosclerotic cardiovascular and malnutrition morbidity） in non-dialyzed ESRD patients.