终末期肾病患者C反应蛋白和缺血性脑卒中的关系及苯那普利的干预作用

Relationship Between C-reactive Protein and Ischemic Stroke in End-stage Renal Disease Patients and the Therapeutic Effect of Benazepril

【目的】研究终末期肾病(ESRD)患者C反应蛋白(CRP)水平与缺血性脑卒中的关系,观察苯那普利在改善ESRD患者微炎症状态中的作用。【方法】以65例ESRD患者为研究对象,监测其CRP水平、血清肌酐(SCr)、头部CT或磁共振指标,分析ESRD患者微炎症状态与缺血性脑卒中的关系。并将存在缺血性脑卒中的患者随机分为苯那普利治疗组和非苯那普利治疗组。用药后12周再次检测CRP浓度。设30例肾功能正常者作对照比较。【结果】ESRD患者血清中炎症指标CRP平均水平明显高于对照组(P<0.01)。根据缺血性脑卒中事件的有无分组,发现阳性组43例患者CRP水平明显高于22例阴性组患者(P<0.05)。根据CRP水平分组,发现CRP增高组缺血性脑卒中发生率高于CRP正常组(P<0.05)。治疗12周后,苯那普利干预组CRP水平下降,与干预前及非干预组相比,差异具有显著性(P<0.05)。【结论】ESRD患者存在微炎症状态,微炎症状态增高了尿毒症患者发生缺血性脑卒中的风险,可能是该事件发生的危险因素之一。苯那普利能改善ESRD缺血性脑卒中患者的微炎症状态。

[Objective]To investigate the relationship between C-reactive protein （CRP） and ischemic stroke in end-stage renal disease（ESRD） patients and the therapeutic effect of benazepril. [Methods]A total of 65 ESRD patients and 30 cases with normal renal function as control participated in the study. CRP, serum creatinine （Scr） and head CT or MRI of them were determined. The presence of micro-inflammation state and its relationship to ischemic stroke were studied. The ischemic stroke patients were randomly divided into two groups to receive benazepril 10mg daily or non benazepril therapy. CRP was assayed again after 12 weeks. [Results]The level of CRP in ESRD patients was higher than that in control. According to the isehemic stroke event happening or not, patients were divided into two groups. Level of CRP was higher in 43 patients with is chemic stroke than that in 22 patients without ischemic stroke. According to the level of CRP, the patients were divided into high CRP level group and normal CRP level group. Significant difference of ischemic stroke event was found between two groups. After, 12 week＇s treatment with benazepril, the level of CRP in isehemic stroke group was lower than before and than that in non-benazepril treatment group. [Conclusion]There is a micro inflammation status in ESRD patients. The micro inflammation status may be a risk factor of ischemic stroke event in ESRD patients. Benazepril can relieve the micro-inflammation state in ESRD patients.