尿毒症维持性血液透析患者超敏C反应蛋白检测临床应用

目的:探讨尿毒症维持性血液透析(maintenance hemodialysis,MHD)患者血清超敏C反应蛋白(hs-CRP)检测的临床意义以及与免疫球蛋白(IgG、IgA、IgM)和补体(C3、C4)的关系。方法:采用乳胶增强免疫透射比浊法测定93例MHD患者和40名健康对照者血清中hs-CRP水平,同时检测IgG、IgA、IgM和C3、C4水平,然后根据hs-CRP参考范围(0～10 mg/L)将93例MHD患者分成hs-CRP正常组63例,hs-CRP异常组30例,并分析3组间的免疫球蛋白和补体的变化。结果:MHD患者hs-CRP较健康对照组明显升高(P0.01),而补体C3则较健康对照组明显降低(P0.01)。hs-CRP异常组IgG明显高于hs-CRP正常组(P0.01)。结论:hs-CRP和IgG的升高对MHD患者继发慢性感染的判断有一定的临床意义,而补体C3水平的降低则是MHD患者体液免疫功能下降的主要原因。

The clinical application of high-sensitivity C reactive protein level in maintenance hemodialysis patients

Objective:To study the clinical significance of serum high-sensitivity C reactive protein(hs-CRP) measurement,and explore the relationships between hs-CRP and immunoglobulin(IgG,IgA and IgM),complement(C3 and C4)in maintenance hemodialysis(MHD) patients.Methods:The level of serum hs-CRP was detected in 93 MHD patients and 40 healthy controls by an automated latex-enhanced immune transmission turbidity method.At the same time,the levels of IgG,IgA,IgM and C3,C4 were determined.According to the normal value(0-10mg/L) of hs-CRP,93 patients were divided into 2 groups:the normal hs-CRP group(63 patients) and the abnormal hs-CRP group(30 patients),and the changes of serum immunoglobulin and complement among the 3 groups were analyzed.Results:The level of hs-CRP in MHD patients was significantly higher than that in healthy controls(P<0.01),but C3 was remarkably lower than that in healthy controls(P<0.01).IgG in the abnormal hs-CRP group of MHD patients was significantly higher than that in the normal hs-CRP group(P<0.01).Conclusions:The increasing of hs-CRP and IgG levels is beneficial to judge the chronic infection of MHD patients,and the decrease of C3 level is the important reason for the decline of humoral immunity in MHD patients.