腹膜透析患者微炎症与营养状况及贫血的关系

Association between malnutrition, anemia and microinflammatory state in patients with CAPD

目的探讨持续不卧床腹膜透析患者体内炎症因子与营养状况及贫血的关系。方法测定87例持续不卧床腹膜透析患者的血红蛋白、血肌酐、血白蛋白及超敏C反应蛋白表达水平，按超敏C反应蛋白〈5mg／L和超敏C反应蛋白≥5mg／L将患者分为两组，并选择20例同龄健康人作为对照。同时进行改良主观综合营养评估，分析两组患者炎症指标与贫血及营养指标的变化的关系。结果持续不卧床腹膜透析患者微炎症发生率为45．97％，超敏C反应蛋白升高组患者血白蛋白、前白蛋白、血红蛋白水平明显低于超敏C反应蛋白正常组；促红细胞生成素每周用量及改良主观综合营养评估评分明显高于超敏C反应蛋白正常组，差异有统计学意义。超敏C反应蛋白水平与血白蛋白、前白蛋白、血红蛋白及血肌酐水平呈负相关（P〈0．05），与改良主观综合营养评估评分呈正相关（P〈0．05）。结论持续不卧床腹膜透析患者存在微炎症状态。微炎症状态在持续不卧床腹膜透析患者营养不良及贫血中起重要作用。

Objective To investigate the association between mgn sensmve tTreacuve protein, malnutrition and anemia in patients with continuous ambulatory peritoneal dialysis. Methods The plasma high sensitive C-reactive protein, hemoglobin, serum creatinine, albumin and lipid were measured in 87 patients with continuous ambulatory peritoneal dialysis. Patients were divided into two groups in terms of the level of high sensitive C-reactive protein： 〈5 mg/L and≥5 mg/L. Meanwhile, the 20 age-matched healthy subjects served as control group. The nutritional status was detected by modified quantitative ＇subjective global assessment. The relationship between difference in nutrition markers, anemia and plasma high sensitive C-reactive protein was evaluated in patients with continuous ambulatory peritoneal dialysis. Results The incidence of microinflammation was 45.97% in patients with continuous ambulatory peritoneal dialysis. The levels of plasma albumin, prealbumin, hemoglobin and hematocrit were obviously lower, and the dosage of erythropoietin and scores of modified quantitative subjective global assessment were obviously greater in high sensitive C-reactive protein group than normal high sensitive C-reactive protein group. Plasma high sensitive C-reactive protein lev- els were negatively correlated with albumin, prealbumin, hemoglobin, serum creatinine, but positively correlated with scores of modified quantitative subjective global assessment. Conclusions There exists a state of microinflammation in patients with continuous ambulatory peritoneal dialysis. Microinflammation plays an important role in malnutrition and anemia in patients with continuous ambulatory peritoneal dialysis.