微炎症状态和肾功能与慢性肾功能衰竭患者合并高磷血症的关系

Relation of micro-inflammatory state and renal function with concomitant hyperphosphatemia in patients with chronic renal failure

目的探讨微炎症状态和肾功能与慢性肾功能衰竭患者合并高磷血症发生的关系。方法回顾性分析47例慢性肾功能衰竭合并高磷血症患者(观察组)和47例单纯慢性肾功能衰竭患者(对照组)的临床资料,比较两组血清微炎症因子[白细胞介素6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)]水平、肾功能指标[血尿素氮、血肌酐、残余肾功能(RRF)]。分析血清炎症因子水平与肾功能相关指标水平的相关性。采用多因素Logistic回归模型分析慢性肾功能衰竭合并高磷血症的影响因素。结果观察组血清hs-CRP、IL-6、TNF-α水平及血尿素氮、血肌酐水平均高于对照组,RRF低于对照组(均P<0.05)。所有慢性肾功能衰竭患者血清hs-CRP、IL-6、TNF-α水平与血尿素氮、血肌酐水平均呈正相关,血清hs-CRP、TNF-α水平与RRF均呈负相关(均P<0.05)。多因素Logistic回归分析结果显示,血清hs-CRP、IL-6、TNF-α水平和血尿素氮、血肌酐水平升高,以及RRF降低是慢性肾功能衰竭患者合并高磷血症的影响因素(均P<0.05)。结论慢性肾功能衰竭合并高磷血症患者机体微炎症状态与肾功能损伤较重。微炎症状态及肾功能损伤可能参与慢性肾功能衰竭患者高磷血症的发生,评估机体微炎症状态及肾功能损伤情况,可为高磷血症的早期防治提供依据。

Objective To investigate the relation of micro-inflammatory state and renal function with concomitant hyperphosphatemia in patients with chronic renal failure.Methods The clinical data of 47 patients with chronic renal failure complicated with hyperphosphatemia(observation group)and 47 patients with simple chronic renal failure(control group)were analyzed retrospectively.The levels of serum micro-inflammatory factors(interleukin 6[IL-6],high-sensitivity C-reactive protein[hs-CRP],tumor necrosis factorα[TNF-α])and the indices of renal function(blood urea nitrogen,serum creatinine,residual renal function[RRF])were compared between the two groups.The correlations of serum levels of inflammatory factors with the levels of renal function-related indices were analyzed.The influencing factors for chronic renal failure complicated with hyperphosphatemia were analyzed using the multivariate Logistic regression model.Results The serum levels of hs-CRP,IL-6,and TNF-α,as well as the levels of blood urea nitrogen and serum creatinine in the observation group were higher than those in the control group,while the observation group yielded a lower RRF as compared with the control group(all P<0.05).Among all patients with chronic renal failure,serum levels of hs-CRP,IL-6,and TNF-αpositively correlated with blood urea nitrogen and serum creatinine levels,whereas serum hs-CRP and TNF-αlevels negatively correlated with RRF(all P<0.05).The results of multivariate Logistic regression analysis revealed that elevated levels of serum hs-CRP,serum IL-6,serum TNF-α,blood urea nitrogen,and serum creatinine,as well as a decline in RRF were the influencing factors for concomitant hyperphosphatemia in patients with chronic renal failure(all P<0.05).Conclusion Severer micro-inflammatory state and renal function damage are observed in patients with chronic renal failure complicated with hyperphosphatemia.Micro-inflammatory state and renal function damage may participate in the occurrence of hyperphosphatemia in patients with chronic renal failure.Evaluating the micro-inflammatory state and renal function damage conditions of the patients can provide a basis for the early prevention and treatment of hyperphosphatemia.