慢性肾衰竭患者心肌标志物、感染标志物和凝血功能的变化及意义

目的 探究不同期慢性肾衰竭患者心肌标志物、感染标志物和凝血功能指标的变化及意义,为慢性肾衰竭患者的临床治疗提供帮助.方法 选取我院收治的103例慢性肾衰竭患者,根据相关指标分为代偿期组(27例)、失代偿期组(36例)和尿毒症期组(40例),选取同期我院检测的30例健康入选者作为对照组,检测各组患者心肌标志物、感染标志物和凝血功能指标变化,并分析相关意义.结果 与对照组相比,不同期慢性肾衰竭患者凝血功能指标活化部分凝血活酶时间(activated partial thromboplastin time,APTT)与血浆凝血酶原时间(prothrombin time,PT)水平均显著低于对照组,心肌标志物肌钙蛋白(troponin I,CTnI)、乳酸脱氢酶(lactic dehydrogenase,LDH)、肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶-II (creatine kinase MB-II,CKMB-II)、和感染标志物降钙素原(procalcitonin,PCT)、C反应蛋白(C-reactive protein,CRP)、纤维蛋白原(fibrinogen,FIB)水平则均显著高于对照组,差异具有统计学意义(P<0.05);随着慢性肾衰竭患者病情恶化,感染标志物(CRP和PCT)、FIB、心肌标志物(CTnI、CKMB-II、LDH和CK)水平依次显著升高,凝血功能指标APPT和PT水平依次显著降低,尿毒症期组患者感染标志物(CRP和PCT)、FIB、心肌标志物(CTnI、CKMB-II、LDH和CK)水平最高,凝血功能指标APPT和PT水平最低,差异有统计学意义(P<0.05).结论 随着慢性肾衰竭患者病情恶化,患者感染标志物、心肌损伤逐渐加重同时血凝状态逐渐降低,为慢性肾衰竭患者的临床治疗提供参考.

Changes and Significance of Myocardial Markers,Markers of Infection and Blood Coagulation in Patients with Chronic Renal Failure

Objective To investigate the changes and significance of myocardial markers, markers of infection and coagulation function in patients with chronic renal failure and generate reference for chronic renal failure treatment.Methods A total of 103 patients with chronic renal failure were selected.According to the related indexes, the patients were divided into three groups: compensatory group (n =27), decompensated group (n =36) and uremia group (n =40), while 30 normal subjects were selected as control group.The changes of myocardial markers, markers of infection and coagulation function were detected and analyzed.Results Compared with the control group, the different periods of blood coagulation in patients with chronic renal failure (APTT), the activated partial thromboplastin time and prothrombin time (PT) were significantly lower than those of control group.The levels of troponin (CTnI), lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase isoenzyme (CKMB-II), and the infection markers of procalcitonin (PCT) and C reactive protein (CRP), fibrinogen (FIB) were significantly higher than the control group (P<0.05).As the disease in patients with chronic renal failure progressed, the infection markers (CRP and PCT), FIB, cardiac markers (CTnI, CKMB-II, LDH and CK) levels were significantly increased, blood coagulation indexes APPT and PT levels were significantly decreased, and the infection markers (CRP and PCT), FIB and cardiac markers (CTnI, CKMB-II, LDH and CK) of uremia patients were the highest, APPT and PT levels of uremia patients were the lowest(P<0.05).Conclusion With the deterioration of patients with chronic renal failure, the infection markers and myocardial injury gradually increase, the state of blood coagulation gradually decrease.It provides a reference for the clinical treatment of patients with chronic renal failure.