慢性肾功能衰竭尿毒症期患者血清C反应蛋白水平及其影响因素分析

The analysis of C-reactive protein in patients with chronic renal failure(uremia period)and the influence factors

目的检测慢性肾功能衰竭(CRF)尿毒症期患者血清C反应蛋白(CRP)水平,分析其影响因素。方法 CRF尿毒症期患者96例,其中规律透析治疗76例,血液透析(HD)41例(HD组),透析1年21例(HD1组)、透析2年20例(HD2组);腹膜透析(PD)35例(PD组),透析1年14例(PD1组)、透析2年21例(PD2组);未透析20例(非透析组)。另选健康成年人20例为正常对照组。检测各组血清CRP水平,分析其影响因素。采用SPSS13.0及PEMS3.1 for windows统计软件。计量资料以(xˉ±s)表示,多组间比较采用方差分析,两组间比较采用t检验或t′检验;多元逐步回归分析相关性。P<0.05为差异有统计学意义。结果 HD、PD、非透析及正常对照组血清CRP水平分别为3.35(0.31~15.80)、3.08(0.13~14.80)、4.41(1.02~17.3)、1.37(1.00~3.02)mg/L,其他三组均较正常对照组升高(P均<0.05);HD1、HD2组分别为1.89(0.31~9.21)、5.59(0.66~15.80)mg/L,P<0.05;PD1、PD2组分别为2.36(0.13~13.80)、3.95(0.37~14.8)mg/L,P>0.05。尿毒症透析患者血红蛋白(Hb)、甘油三酯(TG)、铁(Fe)是CRP的影响因素(P均<0.05)。结论 CRF尿毒症透析患者血清CRP水平增高,HD患者随着透析时间增加CRP水平增加,PD患者CRP水平与透析时间无关;Hb、Fe、TG水平影响血清CRP水平。

Objective To observe the changes of serum C- reactive protein(CRP) levels in patients with chronic renal failure(CRF), and to elucidate the influencing factors for CRP. Methods The study included 96 patients with CRF at uremia period. Among them, 20 were non-dialysis, 41 were hemodialysis(HD) and 35 were peritoneal dialysis(PD) patients. The HD patients were randomly divide into two groups, HD1 with 21 cases and HD2 with 20 cases receiving 1 and 2 years of treatment, respectively. The PD patients were randomly divided into two groups, PD1 with 14 cases and PD2 with 21 cases receiving 1 and 2 years of treatment, respectively. There were also a group of 20 healthy controls. The serum CRP levels were detected in each group. The data was analyzed using the software SPSS13.0 and PEMS3.1 for Windows. Group means were compared using ANOVA and Student's t test, with P<0.05 indicating statistically significant difference. Multiple stepwise regression analyses were performed to elucidate the influencing factors. Results HD, PD and the non-dialysis group with CRF showed significantly higher CRP levels than the normal controls, with mean CRP levels of 3.35(0.31-15.80),3.08(0.13-14.80),4.41(1.02-17.3)and 1.37(1.00-3.02) mg/L, respectively. HD1 group had lower CRP levels than HD2. There was no statistical difference between the PD1 and PD2 group. In all groups,CRP level showed no correlation with creatinine clearance rate(CCR)and serum creatinine(SCr), but had correlation with hemoglobin(Hb), Fe and triglycerides(TG) levels. Conclusions All patients with CRF at uremia period show significantly higher CRP levels than the normal controls. In HD but not PD group, the length of dialysis in hemodialysis patients has positive correlation with CRP level. The levels of Hb, Fe and TG affect the levels of CRP.