摘要
目的探讨维持性血液透析(MHD)尿毒症患者微炎症状态与临床预后的相关性。方法选取2019年1~12月在我院接受MHD的95例尿毒症患者,根据患者预后将其分为预后不良组(再住院及死亡,31例)与预后良好组(64例),比较两组微炎症状态的相关指标,包括炎症因子、贫血及营养指标等,探析微炎症状态与临床预后的相关性。结果预后不良组C反应蛋白(CRP)水平高于预后良好组,差异有统计学意义(P<0.05);两组血清β2微球蛋白(β2-MG)水平比较,差异无统计学意义(P>0.05);预后不良组红细胞计数(RBC)、血红蛋白(Hb)水平低于预后良好组,差异有统计学意义(P<0.05);两组红细胞比容(HCT)、网织红细胞计数(Rtc)水平比较,差异无统计学意义(P>0.05);预后不良组血清清蛋白(ALB)、血清铁蛋白(SF)水平低于预后良好组,差异有统计学意义(P<0.05);两组体重指数(BMI)比较,差异无统计学意义(P>0.05)。多因素Logistics分析显示,CRP水平高(P=0.007)、ALB水平低(P=0.049)均为MHD尿毒症患者发生预后不良的影响因素。结论MHD尿毒症患者微炎症状态与其临床预后密切相关,且CRP水平高、Alb水平低均为MHD尿毒症患者预后不良的独立影响因素,建议予以密切监测。
Objective To investigate the correlation between micro-inflammation status and clinical prognosis in uremic patients undergoing maintenance hemodialysis(MHD).Methods A total of 95 uremic patients who were given MHD admitted to our hospital from January 2019 to December 2019 were selected and divided into the poor prognosis group(n=31,hospitalized and died)and the good prognosis group(n=64)according to their prognosis.The related indexes of micro-inflammation status,in which inflammatory factors,anemia and nutritional indexes were included,were compared and analyzed between the two groups to investigate the correlation between micro-inflammation status and clinical prognosis.Results The level of C-reactive protein(CRP)in the poor prognosis group was higher than that in the good prognosis group,with statistically significant difference(P<0.05);while there was no significant difference in serumβ2 microglobulin(β2-MG)levels between the two groups(P>0.05).The levels of red blood cell count(RBC)and hemoglobin(Hb)in the poor prognosis group were lower than those in the good prognosis group,with statistically significant differences(P<0.05);while there were no significant differences in hematocrit(HCT)and reticulocyte count(Rtc)levels between the two groups(P>0.05).The levels of serum albumin(ALB)and serum ferritin(SF)in the poor prognosis group were lower than those in the good prognosis group,with statistically significant differences(P<0.05);while there was no significant difference in body mass index(BMI)level between the two groups(P>0.05).The multivariate logistics analysis showed that that high levels of CRP(P=0.007)and low levels of ALB(P=0.049)were the impacting factors of poor prognosis in MHD uremia patients.Conclusion The microinflammation status of MHD uremia patients is closely related to their clinical prognosis,and the high CRP level and low Alb level are independent impacting factors of poor prognosis of MHD uremia patients,which should be closely monitored.
作者
李丹
LI Dan(Department of Nephrology and Rheumatology,the First People's Hospital of Shaoguan,Guangdong,Shaoguan 512000,China)
出处
《中国医药科学》
2020年第21期10-13,共4页
China Medicine And Pharmacy
基金
广东省韶关市卫生计生科研项目(Y19076)。
关键词
血液透析
尿毒症
微炎症
临床预后
Hemodialysis
Uremia
Micro-inflammation
Clinical prognosis
