C-反应蛋白水平与老年血液透析患者的关系及临床意义

The Relationship Between the Levels of C-reactive Protein and Elderly Patients with Hemodialysis and Its Clinical Significance

目的评价C-反应蛋白(C-reactive protein,CRP)与老年血液透析患者的营养状态及贫血的关系,探讨其相关临床意义。方法32例老年组及同期40例年轻维持性血液透析患者于透析日空腹抽血测定血清C-反应蛋白(CRP)、转铁蛋白(tranferrin,TF)、白蛋白(albumin,ALB)、血肌酐(serum creatinine,SCr)、尿素氮(blood urea nitrogen,BUN)及血红蛋白(hemoglobin,Hb)、红细胞数(redblood cell,RBC)、红细胞比积(hematocrit,Hct);测定患者肱三头肌皮褶厚度(TSF)、上臂围(AC)、上臂肌围(AMC)等。结果老年维持性血液透析患者TF、ALB、BUN、SCr、Hb、RBC、Hct、TSF、AC、AMC均显著低于年轻组患者,而CRP水平显著高于年轻组患者;老年患者CRP与Hb、Hct、ALB呈显著负相关(P<0.01,P<0.01,P<0.05)。结论血清C-反应蛋白(CRP)是反映维持性血液透析患者早期营养不良及炎症反应的敏感指标。老年血液透析患者营养状况较年轻组患者差,贫血及低蛋白血症严重,贫血、营养不良与炎症反应有明显的相关性。

Objective The article expores the relative clinical significance by evaluating the relationship between the levels of C-reactive protein and the nutrition conditions of the elderly patients with hemodialysis and anemia. Methods 32 elderly cases and 40 young patients with maintenance hemodialysis at the same time are given a blood test in the emply slomach condition and to measure serum CRP, TF, ALB, SCr, BUNHb, RBC, Hct, measure the patients＇ TSF,AC ,AMC etc. Results The TF ,ALB,BUN ,SCr,Hb ,RBC ,Hct,TSF, AC ,AMC of the elderly patients with hemodialysis are all obviously lower than those of the young counterparts, while the CRP is obviously higher. The CRP of the elderly patients with hemodialysis is negatively correlated with Hb, Hct,ALB （ P 〈 0.01, P 〈 0.01, P 〈 0.05 ）. Conclusion Serum CRP is the sensitive index reflecting early malnutrition and micro-inflammation. The nutrition conditions of the elderly patients with hemodialysis are comparatively worse than those of the young. And they all suffer serious anemia and lower albumin. There are obvious correlations among anemia, mahrition and micro-inflammation.