中国血液净化

›› 2005, Vol. 4 ›› Issue (2): 62-64.

• 论著 • 上一篇    下一篇

血液透析患者超敏C-反应蛋白水平与营养状况及心室结构的相关研究

张 冬 陈香美 申力军 魏日胞 张 利 谢院生 刘述文   

  1. 100853 北京，解放军总医院肾内科，解放军肾脏病中心暨重点实验室
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2005-02-12 发布日期:2005-02-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2005-02-12 Published:2005-02-12

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摘要：

目的 评价维持性血液透析（ MHD）患者超敏C-反应蛋白（hs-CRP）水平与营养状况及心室结 构改变之间的关系。方法 选择在我院血液透析中心治疗的MHD患者72例，所有患者均稳定透析3个月以上，以免疫透射比浊法测定其透析前空腹hs-CRP，同时测定所有患者透析前血红蛋白（Hb）、血清白蛋白（Alb）、前白蛋白(PA)、转铁蛋白（TF）、甘油三酯（TG）及总胆固醇（T-Ch），透析后采血测定血浆尿素和下次透析前尿素，计算尿素清除指数（Kt/V）、蛋白分解率（nPCR）及体重指数（BMI），并用二维彩色超声心动图测定心脏左心房前后径（LAD）、左心室前后径（LVD）、室间隔厚度（IVST）、左心室后壁厚度（LVPWT）。根据hs-CRP水平分为升高组（hs-CRP≥3mg/L）及正常组（hs-CRP＜3mg/L），分别观察hs-CRP与血清营养指标及心室结构之间的关系。 结果 升高组Hb、Alb、PA、TF均低于正常组，两组比较差异均有显著性（P ＜0.05），而升高组心室结构指标 LAD、LVD、IVST、LVPWT， 均大于正常组， 两组比较差异均有显著性（P ＜ 0.05）。血 hs-CRP水平与Hb、Alb、PA、TF呈显著负相关，与LAD、LVD、LVPWT呈正相关。 结论 超敏C-反应蛋白作为慢性炎症反应状态最具代表性的标志之一，可以反映维持性血液透析患者的营养状况，并可以用来评价心室结构情况。

关键词: 超敏C-反应蛋白, 血液透析, 营养状况

Abstract:

Objective To investigate serum high sensitive C-reactive protein(hs-CRP) level and its correlation with the nutritional status and the heart structure in maintenance hemodialysis(MHD) patients. Methods This study included 72 MHD patients who were followed-up for more than 3 months in our dialysis center. The serum levels of hs-CRP, hemoglobin, albumin, prealbumin, transferin, triglyceride, cholesterol were determined. The left atrial diameter and interventricular septum thickness, left ventricular posterior wall thickness were measured by echocardiography. These patients were divided into elevated hs-CRP group(hs-CRP≥3mg/L）and normal hs-CRP group（hs-CRP＜3mg/L）. The associations between hs-CRP and nutrition status and the heart structure were analyzed respectively. Results Hb, Alb, preAlb and TF concentration were significantly lower in elevated hs-CRP group. There were negative relationship between hs-CRP and Hb, Alb, preAlb, TF and positive relationship between hs-CRP and left ventricular diameter and interventricular septum thickness, left ventricular posterior wall thickness respectively. Conclusion hs-CRP might be a marker for the nutrition status and ventricular hypertrophy.

Key words: Hemodialysis, Nutritional status 

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