维持性血透患者C反应蛋白与住院率的关系

目的:探讨维持性血液透析(MHD)患者C反应蛋白(CRP)与住院率的关系。方法:70例MHD患者的观察时间为21个月,每3个月测定1次血清白蛋白、前白蛋白、转铁蛋白、血红蛋白和人体学指标及血CRP,根据CRP水平将患者分为两组,记录该期间患者的住院发生事件。结果:CRP>10mg/L组患者各项营养指标平均值均低于CRP<10mg/L组,有显著性差异;而营养不良及动脉粥样硬化性心血管病发病率高(P<0.05、0.025),住院率高,两组间有显著性差异(P<0.05),CRP升高导致住院的相对危险度(RR)为3.0139(R>1)。结论:在MHD患者CRP作为炎症反应的敏感指标通过影响营养状况及促进动脉粥样硬化发生发展导致住院率增加,提示CRP可作为MHD患者临床预后,尤其是短期预后,住院事件的一个预测指标。

The Relationship between C-reaction Protein (CRP)and Nutrition Status and Hospitalization Rate in Maintenance Hemodialysis Patients

Objective: To study the relationship between CRP and nutrition status and hospitalization rate in maintenance hemodialysis (MHD) patients.Method: 70 MHD patients were followed up for 21 months. The serum CRP, albumin, prealbumin, transferin and body mass index in all patients were measured every 3 months. These patients were divided into two group according to their serum CRP and were observed when hospitalized. Result: The serum albumin, prealbumin, transferin and TSF,AC, AMC in patients with the level of CRP over 10 mg/L were significantly lower than those in patients with the level of CRP below 10 mg/L.The prevalence of malnutrition and atherosclerotic cardiovascular disease and the occurrence rate of hospitalization of patients were much higher. The relative risk of high level CRP leading to hospitalization was 3.0139(R > 1) . Conclusion: The CRP, a sensitive marker of inflammation, has effects on nutrition status and atherogeresis and contribute to the increased hospitalization, which indicated that CRP might predict the prognosis,especially the occurrence of hospitalization.