摘要
目的研究在血液透析(HD)过程中维持性血液透析(MHD)患者微炎症状态相关因子的变化.方法选择20例进入MHD的慢性肾衰竭者作为HD组,20例体检者作为对照组.测定HD组患者8个时点(HD前、1/2小时、1小时、3小时、4.5～5小时结束时和HD后12小时、24小时、48小时)血浆C-反应蛋白(CRP)浓度及3个时点(HD前、1/2小时、4.5～5小时结束时)TNF-α和IL-1β浓度,同时测定HD前血浆白蛋白和血脂浓度.对照组测定空腹血以上各指标血浆浓度.结果 (1)HD组8个时点的CRP浓度均较对照组高,其在HD结束后12小时达高峰,HD结束后48小时恢复到HD前水平;(2)HD组3个时点的IL-1β、TNF-α浓度均比对照组高,但各时点间比较无统计学差异;(3)HD 4.5～5小时的TNF-α与HD结束后12小时的CRP浓度呈正相关.HD组低密度脂蛋白(LDL)、白蛋白(ALB)与HD前CRP的浓度分别呈正相关和负相关.结论 (1)MHD患者血浆CRP、IL-1β和TNF-α浓度升高,存在微炎症状态;(2)HD过程中CRP、TNF-α和IL-1β浓度均有升高趋势;(3)MHD患者LDL及ALB的改变可能与机体的微炎症状态有关.
Objective To research the changes of m icroinflamm atory state related-factors in d if- ferent tim e points of hemod ialysis (HD ) procedures among m aintenance hemod ialysis (MHD ) patients. M ethod s Twenty patients w ith chron ic renal failure (CRF) and MHD were selected asHD group and 20 healthy persons were selected as control group. In HD group, 8 tim e points were selected for lab detections: before HD; 0. 5h, 1h, 3h, 4. 5 to 5h, 12h, 24h and 48h afterHD. The p lasm a C-reactive prote in(CRP) con- centrations were detected at all of 8 tim e segm ents. The p lasm a IL-1βand TNF-αconcentrations were de- tected before HD, 0. 5hafterHD and 4. 5 to 5h afterHD. The concentrations of p lasm a ALB, total choles- terol (TC), glyceraldehydes 3-phosphote (TG ), and low-density lipoprote ins ( LDL) were tested in HD group and control group.R esu lts 1. The p lasm a CRP levels at all of the 8 tim e pointwere increased sig- n ificantly in HD group compared w ith control group and appeared a rising trend at 1h afterHD and reached the top at 12h after HD, then decreased gradually and went back to pre-d ialysis levels at 48 hours after HD. 2. The p lasm a concentration of IL-1βand TNF-αwas increased sign ificantly in HD group before HD, at 0. 5h 4. 5-5h afterHD compared w ith control group and there was no d ifference among the 3 tim e points in HD group(P>0. 05). 3. The p lasm a concentration ofTNF-αat 4. 5 to 5h afterHD was positive correla- ted w ith that at 12h after HD. Before HD, p lasm a concentration of CRP was negative correlate w ith ALB and positive correlated w ith LDL.C onc lu sion s 1. CRP, IL-1,β TNF-αincrease in MHD patients, the m i- croinflamm atory state is present in MHD patients. 2. CRP, IL-1βand TNF-αincrease during HD in MHD patients. 3. The decrease of ALB and the increase of LDL m ight be related to m icroinflamm atory state in MHD patients.
出处
《临床内科杂志》
CAS
2005年第7期451-454,共4页
Journal of Clinical Internal Medicine
关键词
血液透析
微炎症状态
慢性肾衰竭
<Keyword>Hemodialysis
Microinflammatory state
Chronic renal failure
