【摘要】 目的 分析腹膜透析患者的C反应蛋白(C-reactive protein,CRP)与铁代谢相关指标间的相关性,探讨微炎症状态(microinflammatory state,MS)对腹膜透析患者铁代谢状态评估的影响。方法 选择我院规律随访的持续性非卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者79例,记录患者年龄、性别、透析时间、收缩压、舒张压,计算尿素清除指数(Kt/V),检测血红蛋白、CRP、血清铁(serum iron,SI)、转铁蛋白饱和度(transferrin saturation,TSAT)、血清铁蛋白(serum ferritin,SF)、血白蛋白、血肌酐、尿素氮。根据患者的CRP水平分为A组(CRP≤8 mg/L)和B组(CRP>8 mg/L);并根据患者的SF水平分为C组(SF<500μg/L)和D组(SF≥500μg/L),应用t检验分别比较A组与B组间年龄、性别、透析时间、收缩压、舒张压、Kt/V值、血红蛋白、SI、TSAT、SF、血白蛋白、血肌酐、尿素氮等指标的差异,以及C组与D组间年龄、性别、透析时间、收缩压、舒张压、Kt/V值、血红蛋白、CRP、SI、TSAT、血白蛋白、血肌酐、尿素氮等指标的差异。采用Pearson相关分析,分析患者的CRP水平与SI、TSAT、SF和收缩压、舒张压水平的相关性。结果 ①与A组比较,B组患者的SF水平显著升高(t=2.976,P<0.01),SI、TSAT、收缩压和舒张压水平降低(分别为t=3.743,P<0.01;t=2.420,P=0.018;t=2.181,P=0.032;t=2.328,P=0.023),血红蛋白水平(t=0.680,P=0.498)差异无统计学意义。②C组与D组间比较年龄、性别、透析时间、收缩压、舒张压、Kt/V值、血红蛋白、CRP、SI、TSAT、血白蛋白、血肌酐、尿素氮差异均无统计学意义(P>0.05)。③CRP与SF呈正相关(r=0.460,P<0.01),与SI呈负相关(r=-0.350,P=0.002)。结论腹膜透析患者的铁代谢指标受到MS的影响,需要联合检测SI、TSAT、SF以及CRP水平以正确评估患者的铁代谢状态。更多还原

【Abstract】 Objective To analyze the correlation between C-reactive protein(CRP) and indicators of iron metabolism,and explore the effect of microinflammatory state on iron metabolism in peritoneal dialysis patients.Methods Seventy-nine patients undergoing continuous ambulatory peritoneal dialysis(CAPD) from our hospital were enrolled in the study.The data of age,sex,PD duration,systolic blood pressure(SBP),diastolic blood pressure(DBP),Kt/V,hemoglobin,CRP,serum iron(SI),transferrin saturation(TSAT),serum ferritin(SF),serum albumin,serum creatinine,and urea nitrogen were collected.The patients were divided into group A(CRP≤8 mg/L) and group B(CRP>8 mg/L) according to the levels of CRP.The patients were also divided into group C(SF<500 μg/L) and group D(SF≥500 μg/L) according to the levels of SF.Comparison of data between groups(A and B,or C and D) was performed using the Student t-test for continuous parametric data.The correlation between CRP and SI,TSAT,SF,SBP or DBP was analyzed by Pearson correlation analysis.Results(1) As compared with group A,the levels of SF were significantly increased(t =- 2.976,P<0.01),and those of SI,TSAT,SBP and DBP were significantly decreased in group B(t= 3.743,P<0.01 i t= 2.420,P = 0.018;t = 2.181,P = 0.032;2 = 2.328,P = 0.023 respectively).There was no significant difference in hemoglobin between group A and group B(t = 0.680,P =0.498).(2) No significant difference was found in the clinical data between group C and group D such as age,sex,PD duration,SBP,DBP,Kt/V,hemoglobin,CRP,SI,TSAT,serum albumin,serum creatinine,and urea nitrogen.(3) Pearson correlation analysis revealed that CRP had a positive correlation with SF(r = 0.460,P<0.01) and a negative correlation with SI(r =- 0.350,P = 0.002).Conclusions The indicators of iron metabolism are constantly affected by microinflammatory state in CAPD patients.Therefore,the combined tests of SI,TSAT,SF and CRP may favor the correct assessment of iron metabolism state.更多还原