慢性肾衰竭患者血清淀粉样蛋白A与肾性贫血、肾性营养不良及心血管疾病的相关性

Relationship Between Serum Amyloid A Level and Renal Anemia、Renal Malnutrition、Cardiovascular Disease in Chronic Renal Failure Patients

目的:研究慢性肾衰竭(CRF)患者血清淀粉样蛋白A(SAA)水平的变化及其与肾性贫血、肾性营养不良及心血管疾病的关系。方法:对80例CRF患者(非透析治疗60例,血液透析20例)、20例正常对照组的临床及实验室资料作回顾性研究。应用ELISA法检测各组SAA水平,分析SAA的变化与其他相关因素。结果:CRF患者无论透析与否,SAA水平均较对照组显著升高(P<0.01),而血液透析(HD组)患者SAA水平较非透析组各期患者更高(P<0.01)。直线相关分析显示CRF患者SAA水平与超声心动图异常(r=0.786,0.733,0.567,0.623,0.549,0.736,P均<0.01)、心血管疾病的发生(r=0.421,P<0.01)、尿素氮(r=0.722,P<0.01)、肌酐(r=0.841,P<0.01)、C反应蛋白(r=0.813,P<0.01)等呈正相关,而与血红蛋白(r=-0.654,P<0.01)、血清白蛋白(r=-0.453,P<0.01)、总胆固醇(r=-0.289,P<0.01)、高密度脂蛋白(r=-0.351,P<0.01)等呈负相关(P<0.05)。结论:CRF患者存在血清SAA水平升高,且与肾性贫血、肾性营养不良及心血管疾病的发生密切相关。

Objective：To study the level of serum amyloid A （SAA）and explore its relationship with renal anemia,renal malnutrition and cardiovascular disease （CVD）in patients with chronic renal failure （CRF）. Methods：Clinical data of 80 CRF patients, including 60 non- dialytic （ND）,20 hemodialysis （HD）, and 20 normal controls were collected and analyzed retrospectively. SAA level was tested by enzyme - linked immunosorbent assay （ ELISA）. To analyze the relationship between SAA level and other relevant factors. Results：The average level of SAA in CRF patients was significantly higher than that in normal control group （P 〈 0.01 ）, and was significantly higher in HD group as compared with ND group（ P 〈 0.01 ）. SAA level increased with the progression of renal dysfunction. A positive correlation of SAA level with abnormal echocardiography （ r = 0. 786,0. 733,0. 567,0. 623,0. 549, 0. 736,P all〈 0.01 ） and cardiovascular disease （r= 0. 421, P〈 0.01 ） was found. SAA level was also positively correlated with BUN（ r = 0. 722, P 〈 0.01 ）, serum creatinine （Scr） （ r = 0. 841, P 〈 0.01 ）, C - reactive protein （CRP） （ r = 0. 813, P 〈 0.01 ）. SAA level was negatively correlated with hemoglobin（Hb） （ r = - 0. 654, P 〈 0.01 ）, serum albumin（Alb） （ r = - 0. 453, P 〈 0.01 ）, TC（ r = - 0. 289, P〈 0.01 ）, HDL（ r = - 0. 351, P〈 0.01 ）. Conclusion： The serum level of SAA was remarkably increased in CRF patients. SAA has a close relation with renal anemia,renal malnutrition and cardiovascular disease.