腹膜透析患者微炎症状态的相关研究

目的观察腹膜透析（CAPD）患者超敏C-反应蛋白（hs-CRP）、白介素-6（IL-6）以及肿瘤坏死因子-α（TNF-α）等相关指标的表达,探讨炎症因子对腹膜透析患者的影响。方法选择74例CAPD患者分别送检hs-CRP、IL-6、TNF-α,同时测定肌酐（Cre）、血钙（Ca）、血磷（P）、血红蛋白（Hb）、胆固醇（Chol）、三酰甘油（TG）、白蛋白（Alb）。根据主观综合性营养评估法（SGA）计算分值,观察腹膜透析患者炎症因子与各生化指标的关系。结果腹膜透析患者血清炎症因子（hs-CRP、IL-6、TNF-α）水平均显著高于正常对照组（P〈0.01）。CRP〉5 mg/L组血清IL-6和TNF-α水平均显著高于CRP〈5 mg/L组;血清Hb、Alb水平及SGA均显著低于CRP〈5 mg/L组,两组比较,差异均有统计学意义（P〈0.01）。而两组Ca、P、Chol和Cre水平比较,差异无统计学意义（P〉0.05）;腹膜高转运患者血清hs-CRP及IL-6水平高于其他各组,组间差异有统计学意义（P〈0.01）。结论腹膜透析患者存在微炎症状态,腹膜高转运功能患者炎症因子升高明显,炎症与低蛋白血症、营养状态差等因素密切相关。

Analysis of microinflammatory state in patients undergoing peritoneal dialysis

Objective To investigate the effect of microinflammatory state to patients undergoing peritoneal dialysis, observe the related indicators of high sensitivity C reactive protein （hs-CRP）, interleukin 6 （IL-6） and tumor necrosis factor-α（TNF-α） in CAPD patients. Methods Serum hs-CRP, IL-6 and TNF-α were measured in the 74 peritoneal dialysis patients, the levels of creati- nine （Cre） ,Calcium （Ca） , phosphorus （P） , hemoglobin （Hb） , cholesterol （Chol） , triglyceride （TG） , albumin （ALB） and so on were measured simultaneously. We calculated the SGA scores according to the subjective global assessment （SGA） , then we an- alyzed the relationship between microinflammatory factors of different groups and hemoglobin, albumin, creatinine, et al. Results Serum hs-CRP, IL-6 and TNF-α were significantly higher in patients than those in the normal control group （P 〈 0.01 ）. The level of haematoglobin, IL-6 and TNF-α in the CRP 〉 5 mg/L group were significantly higher than tile CRP 〈 5 mg/L group, and the level of albumin （Alb） and SGA scores were significantly lower, the difference showed statistical significance （P 〈 0.01 ）. The difference of Ca, P, Chol and Cre between two groups showed no statistical significance （ P 〉 0. 05 ）. Serum hs-CRP and IL-6 were high- er in high peritoneal transport patients than those in the other groups, the difference showed statistical significance （ P 〈 0. 01 ）. Conclusion There is microirdlammatory state in the patients undergoing peritoneal dialysis, microinflammatory factors are higher in high peritoneal transport patients than those in the other groups. Microinflammatory state is related with the lower serum albumin level and the lower nutritional status closely.