终末期肾病患者维持性血液透析微炎症状态与营养水平、心功能的关系

Correlation of micro inflammation to nutritional level and cardiac function of end-stage renal disease patients undergoing maintenance hemodialysis

目的评价终末期肾病(end-stage renal disease,ESRD)患者维持性血液透析(maintenance hemodialysis,MHD)微炎症状态与营养水平及心功能的关系。方法接受MHD治疗的ESRD患者180例,根据血清超敏C反应蛋白(hypersensitivity C reactive protein,hs-CRP)水平分为微炎症组(95例)和非微炎症组(85例),检测并比较两组患者的营养水平及心功能指标。结果微炎症组TP、LVD、LAD、IVSd和LVPWT显著高于非微炎症组,Alb、Hb、PA、EF和E/A值明显低于非微炎症组;差异均有统计学意义(P<0.05)。Pearson相关分析显示,hs-CRP水平与Alb、Hb、EF和E/A呈显著负相关(P<0.05),与LVD、LAD、IVSd和LVPWT呈明显正相关(P<0.05)。结论行MHD治疗的ESRD患者普遍存在微炎症状态,微炎症可能参与了营养不良、左心室重塑的发生和发展。

Objective To examine the correlation of micro inflammatory state to nutritional level and cardiac function of end-stage renal disease(ESRD)patients undergoing maintenance hemodialysis(MHD).Methods Firstly,180 ESRD patients treated with MHD were chosen as the subjects of study.They were then divided into two groups according to the level of hs-CRP observed in the subjects,namely,inflammation group(n=95)and non-inflammation group(n=85).The nutritional level and cardiac function indexes of the two groups were detected and compared.Results The levels of TP,LVD,LAD,IVSd and LVPWT in the inflammation group were significantly higher than those in the non-inflammation group.The values of Alb,Hb,PA,EF and E/A of the inflammation group were significantly lower than those of the non-inflammation group.The differences were statistically significant(P<0.05).Pearson correlation analysis showed that hs-CRP was negatively correlated with Alb,Hb,EF and E/A(P<0.05)and positively correlated with LVD,LAD,IVSd and LVPWT(P<0.05).Conclusions Micro inflammation is found to be prevalent in ESRD patients undergoing MHD and it may contribute to the occurrence and development of malnutrition and left ventricular remodeling.