慢性肾衰竭血液透析与腹膜透析患者微炎症反应的比较及相关因素分析

目的　研究慢性肾衰竭患者两种透析模式对患者自身微炎症状态的影响,探讨与炎症反应相关的因素。方法　抽取4 6例尿毒症血液透析患者和18例腹膜透析患者,2 0例健康对照组(对照组仅检测C反应蛋白)透析前静脉血检测C反应蛋白(CRP)、血肌酐(Scr)、血清白蛋白(ALB)、血清铁蛋白(SF)、Hb、Lp(a)。CRP作为炎症指标,Scr、ALB、SF、Hb、Lp(a)作为相关营养、贫血、心血管疾病指标。比较血液透析(HD)组和腹膜透析(PD)组炎症指标。各组内根据CRP水平分为两组,CRP >10mg/L为A组,CRP <10mg/L为B组,比较A、B两组各相关因素(Scr、ALB、Lp(a)等)。结果　HD组炎症因子C反应蛋白高于腹膜透析组(P <0 .0 5 )。各相关因素的比较:HD组内A组Lp(a)高于B组(P <0 .0 5 ) ,A组Hb、ALB低于B组(P <0 .0 5 ) ;A组Scr低于B组,A组SF高于B组,但无统计学差异(P >0 .0 5 )。PD组内A组Lp(a)高于B组(P <0 .0 5 ) ,A组HDL、Hb、ALB低于B组(P <0 .0 5 ) ;A组SF、Scr低于B组,但无统计学差异(P >0 .0 5 )。结论　血液透析患者微炎症反应比腹膜透析患者严重,微炎症反应与ALB、Hb、Lp(a)有关。

The comparition between hemodialysis patients and peritoneal hemodialysis patients in microinfection and the factors associated with microinfection

Objective To study the influence of the two kinds of dialysis to patients' microinfection ,and evaluate the factors associated with microinfection.Methods To explore 46 blood hemodialysis patients ,18 peritoneal dialysis patients and 20 normal controls,plasma CRP, Scr, ALB, SF, Hb, Lp(a) are measured before hemodialysis. CRP is figured as infectional index. Scr?ALB?SF?Hb?Lp(a) are considered as indexes associated with nutrition,anemia and cardiovascular disease.To compare with the infectional indexes between hemodialysis patients and peritoneal dialysis patients.Hemodialysis patients and peritoneal dialysis patients are divided into A (CRP>10mg/L) and B (CRP<10mg/L) themselves. To compare with the factors (Scr?ALB?Lp(a) et) between A and B.Results HD patients' infectional indexes are higher than PD patients',such as CRP(P<0.05). The comparitions of associated factors:In HD patients ,A' Lp(a) higher than B'(P<0.05), A' Hb?ALB are lower than B'(P<0.05); A' Scr is lower than B' (P>0.05), A' SF is higher than B' (P>0.05). The comparitions of associated factors:In PD patients ,A' Lp(a) is higher than B'(P<0.05); A' Hb?ALB are lower than B'(P<0.05); A' Scr and SF are lower than B' (P>0.05).Conclusion HD patients' infection is more serious than PD's, and infection is associate with ALB,Hb,and Lp(a).