血液透析患者的CRP和MDA测定的意义

The significance fo crp and mda in hemodialysis

目的探讨血液透析治疗对终末期肾衰CRP和MDA的影响。方法选择炎症反应产物C反应蛋白(CRP)和氧化应激产物丙二醛(MDA)作为预测动脉粥样硬化的实验指标。选取健康对照组、尿毒症保守治疗组、尿毒症血液透析组,利用免疫散射比浊法和硫代巴比妥酸分光光度法分别测定各组血清的CRP和MDA水平;通过对比各组间血清中CRP和MDA的变化,推测持续血液透析对尿毒症患者动脉粥样硬化的影响。结果:①健康对照组血清CRP为0·76±0·26mg/L、MDA为7·79±0·73nmol/L;②尿毒症保守治疗组血清CRP为1·36±0·24mg/L、MDA为10·20±0·49nmol/L,均高于健康对照组且差异有显著性(P<0·05);③尿毒症血液透析组CRP为2·24±0·41mg/L、MDA为12·23±0·88nmol/L,均高于保守治疗组且差异有显著性(P<0·05)。结论尿毒症患者血清的CRP和MDA较健康对照组明显升高,血液透析患者两种指标较保守治疗组明显升高,这提示维持性血液透析可能通过促进炎症反应和氧化应激而促进了终末期肾衰患者动脉粥样硬化发生。

Objective： To explore the effects of hemodialysis on CRP and MDA in patients with end-stage renal disease. Methcds： Choose serum CRP and MDA as indicators of inflammation and oxiditive stress which are considered as the important factors of atherosclerosis. The enrolled patients were divided into three groups： health cases, conservative therapy cases and hemdialysis cases. All cases were detected the concentration of CRP and MDA in serum by immunoturbidimetry and spectrophotography. Then compare the results of every two groups, to deduce the effect of maintained hemcdtialysis on atherosclerosis progression. Results： ①Serum CRP of health group is 0.76 ± 0.26 mg/L, and MDA is 7.79± 0.73 nmol/L; ②Serum CRP of conservative therapy group is 1.36 ± 0.24 rag/L, and MDA is 10.20 ± 0.49 nmol/L,which have significant statistical differences （ P 〈 0.05 ） vs the health group; ③Serum CRP of hemodialysis group is 2.24± 0.41 mg/L, and MDA is 12.23 ±0.88 nmol/L, which have significant statistical differences （ P 〈0.05）vs the conservative therapy group. Conclusions： CRP and MDA in conservative therapy significantly increase than health cases, maintained hemodialysis than conservative ones, which suggests maintained hemodialysis promotes atherosclerosis pogression in end-stage renal failure.