微炎症状态和蛋白能量消耗在维持性腹膜透析人群中的特点

发布时间：2018-03-21 21:18

  本文选题：腹膜透析　切入点：持续不卧床　出处：《重庆医学》2017年23期 　论文类型：期刊论文

【摘要】：目的探讨微炎症状态和蛋白质能量消耗(PEW)在维持性腹膜透析(MPD)患者中发病特点,分析其相关性。方法选择2012年3月至2015年9月该院收治的MPD患者96例。采用改良SGA法、汉化营养不良原炎症评分(SMI)评分和清蛋白(Alb)进行营养评估,微炎症状态评估采用酶联免疫吸附试验(ELISA)法检测血浆超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)水平,同时检测Alb、血清总蛋白(TP)、前清蛋白(PA)、血红蛋白(Hb)、转铁蛋白(TF)、血肌酐(Scr)、血尿素氮(BUN)、血清胆固醇(Tch)等指标。结果 MPD患者PEW发生率36.50%,其中大于65岁患者占62.86%,透析龄大于2年患者占57.10%,糖尿病肾病患者占40.00%;MPD患者hs-CRP5 mg/L占58.33%,其中大于65岁患者占42.86%,透析龄大于2年患者占60.71%,糖尿病肾病患者占32.14%。PEW组糖尿病肾病患者、年龄、透析龄、hs-CRP、TNF-α、IL-6高于非PEW组,而BMI、TP、Alb、PA、Hb、Tch、中臂围(MAC)、中臂肌围(MAMC)的比例低于非PEW组(均P0.05);hsCRP5mg/L组年龄、透析时间、TNF-α、IL-6高于hs-CRP≤5 mg/L组,而TP、Alb、PA、TF、Hb、Kt/V≥1.72的比例低于hsCRP≤5mg/L组(均P0.05)。校正性别、年龄、透析龄影响因素,MPD患者hs-CRP水平与Alb、PA、TF、Tch、Scr、TG水平呈不同程度负相关;患者IL-6水平分别与Alb、PA、TF、Tch、TG呈不同程度负相关;患者TNF-α水平与Alb、PA、TF、TG、Tch水平呈不同程度负相关(均P0.05)。多因素分析显示,高龄、透析龄、微炎症状态、低蛋白血症是PEW的独立危险因素(P0.05)。结论 MPD患者PEW、微炎症状态发生率高,PEW、微炎症状态发生具有高龄、透析龄长的特点,糖尿病患者更易并发PEW、微炎症状态,高龄、透析龄、微炎症状态、低蛋白血症是PEW的独立危险因素。
[Abstract]:Objective to investigate the characteristics of microinflammation and protein energy consumption (PEW) in patients with maintenance peritoneal dialysis (MPD) and to analyze their correlation. Methods 96 patients with MPD were selected from March 2012 to September 2015. The levels of plasma hypersensitive C-reactive protein (hs-CRPN), tumor necrosis factor- 伪 (TNF- 伪) and interleukin-6 (IL-6) in plasma were measured by enzyme-linked immunosorbent assay (Elisa). At the same time, Alb, serum total protein (TTP), prealbumin (PAA), hemoglobin (HB), transferrin (TFN), creatinine (Cr), bun (bun), serum cholesterol (TC) were detected. Results the incidence of PEW in MPD patients was 36.50, of which 62.86b was more than 65 years old, and the dialysis age was older than 65 years. The patients with diabetic nephropathy accounted for 57.10% of the total, and the patients with diabetic nephropathy accounted for 58.33% of hs-CRP5 mg/L, including 42.86% of the patients over 65, 60.71% of the patients with dialysis older than 2 years, and 60.71% of the patients with diabetic nephropathy, and the patients with diabetic nephropathy accounted for the patients with diabetic nephropathy in the 32.14%.PEW group. Age, age, hemodialysis age, TNF- 伪 IL-6 of hs-CRPU TNF- 伪 group was higher than that of non-#en1# group, while the ratio of BMI-TPTPPABPA-PAHbTch, middle arm circumference (MAC), middle arm muscle (MAC) group was lower than that of non-#en1# group (all P0.05hsCRP5mg / L age, dialysis time was higher than that of hs-CRP 鈮，

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