维持性血液透析并脑出血患者血浆超敏C反应蛋白、D-二聚体与同型半胱氨酸的变化

Changes of high-sensitivity C-reactive protein,D-dimer,and homocysteine in the plasma of the maintenance hemodialysis patients with cerebral hemorrhage

目的探讨维持性血液透析并脑出血患者HsCRP、D-D及HCY的变化与意义。方法选取医院血液净化中心维持性血液透析并发脑出血患者30例(维持性血液透析脑出血组),维持性血液透析未并发脑血管病为维持性血液透析组(34例),医院体检中心健康体检者(正常对照组)31例,分别测定各组患者血清HsCRP、D-D、HCY及尿素动力学指数(Kt/V)进行统计分析。结果 (1)维持性血液透析脑出血组和单纯维持性血液透析组患者Hs-CRP、D-D及HCY水平较正常对照组显著升高(P<0.05);(2)维持性血液透析脑出血组Hs-CRP、D-D及HCY水平较单纯MHD组显著升高(P<0.05);(3)MHD脑出血组患者Kt/V与血清HsCRP、D-D及HCY呈负相关(r=-0.633,r=-0.645,r=-0.655,均P<0.005),单纯MHD组Kt/V与HsCRP、D-D及HCY间无相关性(均P>0.05)。结论 MHD患者血浆Hs-CRP、D-D及Hcy水平增高对对预测MHD患者脑出血发生及早期诊断具有重要的临床意义。

Objective To investigate the changes high-sensitivity C-reactive protein,D-dimer,and homocysteine in the plasma of the MHD patients with CH.Methods 31 Healthy subjects from the examination center at our hospital（control group）,30 MHD patients with cerebral hemorrhage from the blood purification center at our hospital（MHD complicating cerebral hemorrhage group）,34 MHD patients without cerebrovascular diseases from the blood purification center at our hospital（simple MHD group）,were detected HsCRP,DD,HCY in their serum and dialysis adequacy（Kt/V） for statistical analysis.Results（1）The levels of Hs-CRP,DD and HCY in the serum of the MHD patients were significantly higher than those in control group（P 0.05）;（2） The levels of Hs-CRP,DD and HCY in the serum of MHD patients with cerebral hemorrhage group were significantly higher than those in the simple MHD group（P 0.05）;（3）In the complicating cerebral hemorrhage group,Kt/V was negatively correlated to the HsCRP,DD and HCY（r=-0.633,r=-0.645,r=-0.655,P 0.005）,however,there was no correlation between Kt/V and HsCRP,DD and HCY in the simple MHD group（P 0.05）.Conclusion Hs-CRP,DD and HCY levels play important roles in predicting occurrence of cerebral hemorrhage in MHD patients.