终末期肾病腹膜透析患者微炎症状态与营养状况的关系

Microinflammatory state correlate with nutritional status in patients with end-stage renal disease undergoing peritoneal dialysis

目的探讨终末期肾病(ESRD)长期腹膜透析患者血清C-反应蛋白(CRP)和白细胞介素-6(IL-6)水平变化及与营养状况的关系。方法检测山东中医药大学第二附属医院肾内科ESRD患者非透析组、腹膜透析组和对照组的CRP、IL-6、血清白蛋白(Alb)、血红蛋白(Hb)、转铁蛋白(TF)、血肌酐(Scr)水平。根据CRP水平将膜透析组分为CRP≤6mg/L组和CRP>6mg/L组.并比较两组IL-6、Alb、Hb、TF、Scr的水平。结果腹膜透析组CRP、IL-6水平明显高于非透析组(P<0.05)和对照组(P<0.01),腹膜透析组CRP、IL-6分别与Alb、Hb、TF呈负相关(r=-0.543～-0.379,P<0.05),与Scr无相关关系(r=0.258、0.245,P>O.05)。结论ESRD腹膜透析患者体内存在微炎症状态,CRP、IL-6是终末期肾病腹膜透析患者微炎症状态较好的预测指标,并可反映腹膜透析患者的营养状况。

Objective To investigate serum C-reactive protein （CRP）, interleukin-6（IL-6） level and their correlation with nutritional status in patients with end-stage renal disease（ESRD） undergoing peritoneal dialysis. Methods The serum levels of CRP, IL-6, albumin（Alb）, hemoglobin（Hb）, transferin（TF）, serum creatinine （Scr） were determined in normal controls, patients without peritoneal dialysis and with peritoneal dialysis. The peritoneal dialysis patients were divided into CRP ≤ 6 mg/L group and CRP 〉 6 mg/L group. Thc levels of IL- 6, Alb, Hb, TF and Scr were compared between this two groups. Results The serum CRP, IL-6 in peritoneal dialysis group were significantly higher than those of non-peritoneal dialysis group（P 〈 0.05） and normal control group （P〈 0.01）. In peritoneal dialysis group CRP and IL- 6 were negatively correlated with Alb, Hb and TF, respectively （r = -0.543～-0.379, P〈 0.05）, but not correlated with Scr （r = 0.258, 0.245, P〉 0.05）. Conclusion There is microinflammatory state with peritoneal dialysis in the ESRD patients. CRP and IL-6 are the better predictive markers of microinflammatory state and nutrition status.