摘要
目的观察尿毒症血液透析病人网织红细胞(RET)、血清转氨酶水平,并探讨二者与尿毒症血液透析预后的关系。方法选取2015年6月至2016年6月四川省人民医院收治的尿毒症血液透析病人78例,同时选取同期体检健康者78例为对照组。采用全自动血液分析仪检测RET水平,采用酶联免疫吸附(ELISA)法测定病人血清转氨酶水平,采用多功能全自动生化分析仪进行肾功能指标测定,采用彩色多普勒超声心动仪测定研究对象心功能指标,并分析尿毒症血液分析病人RET、血清转氨酶与心、肾功能指标的相关性。结果与对照组[(101.48±33.41)μmol/L、(6.49±2.11)mmol/L、(16.43±5.07)mg/L、(112.23±20.31)mL、(37.28±5.43)mL]相比,尿毒症血液透析病人透析前后血肌酐(Scr)[(186.45±61.38)μmol/L、(138.76±46.81)μmol/L]、血尿素氮(BUN)[(13.21±4.87)mmol/L、(9.63±3.18)mmol/L]、β2微球蛋白(β2-MG)[(29.14±9.23)mg/L、(22.47±6.94)mg/L]、左室舒张期末容积(LVEDV)[(124.98±20.53)mL、(118.43±16.13)mL]、左室收缩期末容积(LVESV)[(58.12±5.84)mL、(43.15±5.67)mL]水平均升高,差异有统计学意义(P<0.05);与透析前相比,透析后尿毒症血液透析病人血清血清转氨酶、RET百分比、Scr、BUN、β2-MG、LVEDV、LVESV水平下降(P<0.05)。尿毒症血液透析病人透析前、后RET百分比、血清转氨酶水平与Scr、BUN、β2-MG、LVEDV及LVESV均呈正相关(P<0.05)三年存活组病人透析前、透析后RET百分比[(1.32±0.14)×10^(9)/L、(1.11±0.12)×10^(9)/L]、血清AST[(49.26±6.94)U/L、(39.24±6.83)U/L]及ALT[(53.94±7.09)U/L、(42.96±7.03)U/L]水平均明显低于死亡组[(1.53±0.16)×10^(9)/L、(1.31±0.14)×10^(9)/L、(56.34±7.63)U/L、(45.37±6.24)U/L、(61.49±8.17)U/L、(48.38±6.26)U/L],差异有统计学意义(P<0.05)。结论RET百分比、血清转氨酶在尿毒症血液透析病人透析前呈现高水平,透析后水平降低,RET、血清转氨酶水平的测定可能有助于判断尿毒症血液透析病人的预后。
Objective To observe the levels of reticulocyte(RET)and serum aminotransferase in uremic hemodialysis patients,and to explore the relationships between them and the prognosis of uremic hemodialysis patients.Methods Seventy-eight cases of uremic hemodialysis patients admitted to Sichuan Provincial People′s Hospital from June 2015 to June 2016 were selected,and 78 healthy per‐sons in the same period were selected as the control group.RET level was measured by automatic blood analyzer,serum transaminase level was measured by enzyme-linked immunosorbent assay(ELISA),renal function was measured by multi-functional automatic bio‐chemical analyzer,cardiac function was measured by color Doppler echocardiography,RET in uremic patients with hematological anal‐ysis was analyzed,and the correlations between RET,serum transaminase and cardiac,renal functions in uremic patients with hemato‐logical were analyzed.Results①The serum creatinine(Scr)[Before dialysis:(186.45±61.38)μmol/L vs.After dialysis:(138.76±46.81)μmol/L vs.Control group:(101.48±33.41)μmol/L],blood urea nitrogen(BUN)[Before dialysis:(13.21±4.87)mmol/L vs.After di‐alysis:(9.63±3.18)mmol/L vs.Control group:(6.49±2.11)mmol/L],β2-microglobulin(β2-MG)[Before dialysis:(29.14±9.23)mg/L vs.After dialysis:(22.47±6.94)mg/L vs.Control group:(16.43±5.07)mg/L],left ventricular end diastolic volume(LVEDV)[Before dialysis:(124.98±20.53)mL vs.After dialysis:(118.43±16.13)mL vs.Control group:(112.23±20.31)mL]and left ventricular end systolic vol‐ume(LVESV)[Before dialysis:(58.12±5.84)mL vs.After dialysis:(43.15±5.67)mL vs.Control group:(37.28±5.43)mL]before and af‐ter dialysis in uremic hemodialysis patients were higher than those of the control group,and the difference was statistically significant(P<0.05);compared with before dialysis,the levels of serum aminotransferase,RET%,Scr,BUN,β2-MG,LVEDV,LVESV in uremic hemodialysis patients after dialysis decreased,with statistical significances(P<0.05).②Before and after dialysis,RET%and serum aminotransferase levels in were positively correlated with Scr,BUN,β2-MG,LVEDV and LVESV,and the differences were statistically significant(P<0.05).③The levels of serum RET%[(1.32±0.14)×10^(9)/L,(1.11±0.12)×10^(9)/L],AST[(49.26±6.94)U/L,(39.24±6.83)U/L]and ALT[(53.94±7.09)U/L,(42.96±7.03)U/L]before and after dialysis in the three-year survival group were significantly lower than those in the death group[(1.53±0.16)×10^(9)/L,(1.31±0.14)×10^(9)/L,(56.34±7.63)U/L,(45.37±6.24)U/L,(61.49±8.17)U/L,(48.38±6.26)U/L],and the differences were statistically significant(P<0.05).Conclusions RET and serum aminotransferase in uremic hemodialy‐sis patients are high before dialysis,and the levels decrease after dialysis.The determination of RET and serum aminotransferase may be helpful in judging the prognosis of hemodialysis patients with uremia.
作者
张文婷
郑娜
焦亮
ZHANG Wenting;ZHENG Na;JIAO Liang(Intensive Care Center,Sichuan Academy of Medical Sciences(Sichuan People's Hospital),Chengdu,Sichuan 610041,China;Urology Department,Sichuan Academy of Medical Sciences(Sichuan People's Hospital),Chengdu,Sichuan 610041,China;Department of Rehabilitation,Sichuan Civil Affairs Rehabilitation Hospital,Chengdu,Sichuan 610041,China)
出处
《安徽医药》
CAS
2021年第7期1437-1441,共5页
Anhui Medical and Pharmaceutical Journal
