腹膜透析对肾衰竭患者微炎性反应指标的影响

目的：探讨肾衰竭患者腹膜透析前后超敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子（TNF-α）和血清清蛋白（Alb）等指标的水平变化,并观察腹膜透析对其的影响。方法：选择2006年6月～2007年12月我院肾内科诊断为慢性肾衰竭患者35例为透析组,分别于透析前后抽血检查hs-CRP、IL-6、TNF-α和Alb,并选择同期30例健康者为对照组。结果：腹膜透析组透析前hs-CRP、IL-6、TNF-α和Alb水平明显升高,与对照组比较,差异均有统计学意义（P〈0.05）;腹膜透析治疗后血清hs-CRP和Alb水平较透析前降低（P〈0.05）,IL-6和TNF-α水平变化不明显。结论：肾衰竭患者经腹膜透析治疗后微炎症状态有所好转,但未消退。监测这些指标的变化可作为观察腹膜透析患者心血管疾病、感染和营养不良等常见并发症和预测不良后果的手段之一。

The effect of peritoneal hemodialysis on micro-inflammatory response indicators in patients with renal failure

Objective：To evaluate the level change of the high-sensitivity C-reactive protein （hs-CRP）,interleukin-6 （IL-6）,tumor necrosis factor （TNF-α）,serum albumin （Alb） and the other indicators in the patients with renal failure before and after peritoneal hemodialysis,the effect of peritoneal hemodialysis was observed. Methods：35 cases of patients with renal failure from June 2006 to December 2007 in Nephrology Department of our hospital as peritoneal hemodialysis group,hs-CRP,IL-6,TNF-α and Alb of the blood were tested before and after dialysis. 30 cases of healthy persons as control group. Results：The hs-CRP,IL-6,TNF-α and Alb levels of the peritoneal hemodialysis group pre-dialysis were significantly elevated compared with those of the control group （P〈0.05）; the levels of hs-CRP and Alb were significantly lower compared with pre-dialysis （P〈0.05）,the levels of IL-6 and TNF-α did not change significantly. Conclusion：The patients with renal failure treated by peritoneal hemodialysis has improved micro-inflammatory state,but don ＇t subside. Monitoring of these indicators change can be used as one of the means for the observation of peritoneal hemodialysis patients with cardiovascular disease,common complications such as infection and malnutrition and to predict adverse effects.