中国血液净化

›› 2004, Vol. 3 ›› Issue (10): 540-542.

• 论著 • 上一篇    下一篇

C－反应蛋白水平与血液透析患者贫血和促红细胞生成素抵抗的关系

余月明 郭 虹 段 建 曹礼应 王柏青 余开慧 卓红爱   

  1. 650032 昆明，成都军区昆明总医院肾病内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2004-10-12 发布日期:2004-10-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2004-10-12 Published:2004-10-12

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摘要：

目的 探讨维持性血液透析患者 C－反应蛋白（CRP）与贫血和促红细胞生成素（EPO）疗效的关系。方法 96例维持性血液透析患者于透析日空腹采血测定血红蛋白（Hb）、红细胞比积（Hct）、血清铁蛋白（SF）、转铁蛋白饱和度（TSAT）以及血浆白蛋白（Alb）、血脂、纤维蛋白原（Fib）和CRP，记录重组人红细胞生成素（rHuEPO）用量，以rHuEPO用量/Hct比值（EPO/Hct）作为EPO抵抗指标。结果 96例患者中57例（占59.4％）CRP升高（CRP增高组），39例（占40.6％）正常（CRP正常组），CRP增高组rHuEPO用量、EPO/Hct比值、Fib和CRP水平均高于CRP正常组，Hct、Hb、血浆白蛋白（Alb）低于CRP正常组；多因素逐步回归分析表明，影响EPO/Hct比值的因素有CRP、Alb和透析疗程（R2＝0.388， P＝0.039）。结论 微炎症反应在维持性血液透析患者中较为常见， C－反应蛋白升高是促红细胞生成素抵抗的独立影响因素。

关键词: 慢性肾功能衰竭, 血液透析, C－反应蛋白, 贫血

Abstract:

Objective To investigate serum C-reactive protein (CRP) level and its correlation with erythropoietin (EPO) resistance. Methods Ninety-six maintenance hemodialysis patients (including 56 men and 40 women), aged (50.6±14.9) years were studied. Blood samples were collected at the day on hemodialysis for the determination of serum albumin, iron indicts, fibrinogen, CRP, hemoglobin (Hb) and hematocrit (Hct). The EPO resistance was defined according to the recombinant human erythropoietin (rHuEPO) dosage to Hct (EPO/Hct) ratio. Results Patients in elevated serum-CRP group (57 cases，59.4％) had higher dosage of rHuEPO, EPO/Hct ratio, and fibrinogen level, but lower levels of serum albumin, Hb and Hct, as compared with the patients in normal serum-CRP group (39 cases， 40.6％). Multiple stepwise regression analysis showed that the levels of serum albumin, serum-CRP and the duration of hemodialysis were the best predictors of EPO/Hct (R2=0.338, P=0.039). Conclusions There is a prevalence of microinflammatory state in the maintenance hemodialysis patients. The microinflammatory state is the most important predictor of the EPO resistance.

Key words: Hemodialysis, C－Reactive Protein, Anemia 

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