大黄对非尿毒症慢性肾衰竭患者微炎症状态的影响

目的探讨大黄对非尿毒症慢性肾衰竭(chronic renal failure,CRF)患者微炎症状态的影响。方法选择2010年1月至2011年3月在南昌大学第二附属医院及江西省肿瘤医院门诊及住院的非尿毒症CRF患者60例,按不同的治疗方法分为治疗组和对照组,每组30例。对照组患者常规给予降压药、红细胞生成素及对症治疗;治疗组在对照组治疗的基础上加用生大黄10g开水泡服,1次.d-1。2组疗程均为2周。选择同期在南昌大学第二附属医院门诊体检科体检的健康者(正常对照组)30例。治疗组和对照组在治疗前后分别检测血清肌酐(Scr)、淀粉样蛋白A(SAA)、超敏C反应蛋白(hs-CRP)的水平,同时计算内生肌酐清除率(Ccr)。并与正常对照组进行对比。结果 2组患者治疗后血清Scr和Ccr水平与治疗前比较差异均无统计学意义(均P>0.05),2组患者治疗前血清SAA、hs-CRP水平均较正常对照组显著升高(均P<0.05),对照组患者治疗前血清SAA、hs-CRP水平与治疗后比较差异均无统计学意义(均P>0.05),而治疗组患者治疗后血清SAA、hs-CRP水平均较治疗前、对照组显著下降(均P<0.05)。相关性分析结果显示,60例非尿毒症CRF患者治疗前血清SAA水平与血清hs-CRP水平呈正相关(r=0.866,P<0.05)。结论非尿毒症CRF患者存在微炎症状态。大黄能改善非尿毒症CRF患者微炎症状态,但对其肾功能无明显地改善。

Effects of Rhubarb on Microinflammation State in Non-uremic Patients with Chronic Renal Failure

Objective To explore the effects of rhubarb on microinflammation state in non-uremic patients with chronic renal failure.Methods Sixty non-uremic outpatients and inpatients with chronic renal failure treated from Out-patients and Hospitallization of the Second Affiliated Hospital of Nanchang University and Jiangxi Province Tumor Hospital from January 2010 to March 2011 were randomly divided into treatment group and control group,with 30 patients in each group.All patients were routinely offered antihypertensive drugs,erythropoietin and heteropathy.In addition,patients in treatment group were additionally given rhubarb decoction(10 g once daily).Treatments were maintained for 2 weeks.Thirty healthy subjects from the Out-patients Department of Physical Examination of the Second Affiliated Hospital of Nanchang University were selected as normal controls.The levels of serum creatinine(Scr),amyloid A(SAA) and high sensitivity C-reative protein(hs-CRP) were detected before and after treatment,and creatinine clearance rate(Ccr) was calculated.Results No significant changes in levels of Scr and Ccr were found in patients after therapy(all P>0.05).Compared with normal controls,levels of SAA and hs-CRP obviously increased in patients before treatment(all P<0.05).Compared with values before treatment,levels of SAA and hs-CRP did not changed in control group(all P>0.05),but obviously decreased in treatment group after therapy(P<0.05).Furthermore,levels of SAA and hs-CRP in treatment group were significantly lower than those in control group after therapy(all P<0.05).There was a positive relationship between SAA levels and hs-CRP levels before treatment in non-uremic patients with chronic renal failure(r=0.866,P<0.05).Conclusion Microinflammation state exists in non-uremic patients with chronic renal failure and can be improved by rhubarb,which has no obvious influence on renal function.