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慢性肾脏病非透析患者微炎症状态分析

, PP. 348-351

Keywords: 慢性肾脏病,微炎症,超敏C反应蛋白,白细胞介素-6,脂蛋白(a)

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Abstract:

目的探讨慢性肾脏病(CKD)非透析患者微炎症状态标志物与肾功能及临床传统心血管病危险因素的关系。方法选择CKD非透析患者100例,依据美国NKF-K/DOQI的肾功能分期标准,将患者分为CKD1期、CKD2期、CKD3期、CKD4期、CKD5期,每组20例。同期25例本院的健康体检者作为健康对照组。分别测定血清超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、脂蛋白a(LPa)水平(均采用酶联免疫吸附法)及相关临床指标,比较不同CKD分期中血清hs-CRP、IL-6、LP(a)水平,并探讨炎症因子与肾功能及临床传统心血管病危险因素之间的关系。结果①CKD组患者的血清hs-CRP(3.54±2.57)mg?L-1高于健康对照组(1.85±1.36)mg?L-1、IL-6(2.10±1.29)pg?mL-1高于对照组(1.53±0.93)pg?mL-1、LP(a)(326.34±124.39)mg?L-1高于对照组(152.32±63.46)mg?L-1,差异均有统计学意义(P<0.05)。②与CKDl、2、3期患者比较,CKD5期患者血清IL-6含量显著升高(P<0.05),CKD4、5期患者血清hs-CRP含量也显著升高(P<0.05);与CKD1、2期患者比较,CKD5期患者血清LP(a)含量显著升高(P<0.05)。③相关分析显示,CKD患者血清hs-CRP与血肌酐呈正相关性(r=0.502,P<0.01);LP(a)水平与血肌酐呈正相关性(r=0.274,P<0.05)。结论CKD患者微炎症状态标志物hs-CRP、IL-6、LP(a)本身可能作为损伤因子,参与肾功能恶化,并可能与心血管病变的发生有关。微炎症因子在CKD患者中有早期预测心血管疾病(CVD)的重要作用,有望用于CKD患者并发心血管疾病的早期诊断、危险分层。

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