血浆五聚素水平在慢性肾脏病患者的临床意义樊雨良刘沁陆遥富秀英陶晓阳李花(上海市黄浦区中心医院肾内科200002)【摘要】目的：探讨慢性肾脏病(CKD)患者血浆五聚素3(PTX3)水平与肾小球滤过率(GFR)、24小时尿蛋白定量的关系。方法：120例CKD患者分四组，每组30例：①CKD3期组；②CKD4期组；③CKD5期非透析组；④CKD5期透析组,另选健康对照组：健康正常人30人。患者均常规检测尿素氮、肌酹、24小时尿蛋白定量等，用简化MDRD公式计算各组GFR,用放免法测定PTX3、超敏C反应蛋白(hs・CRP)、肿瘤坏死因子(TNFa)o结果:1.PTX3、hs-CRP>TNFa等炎症介质在①组、②组、③组、④组均明显高于健康对照组；(P<0.05)o2.随着GFR的降低，PTX3水平逐渐升高：①组<②组<③④组(P<0.01)o3.hs-CRP随着GFR的降低，①组、②组、③④组呈逐渐上升趋势，但无统计学意义(P>0.05)o4.TNFa随着GFR的降低，①组、②组、③④组呈逐渐上升趋势，但①组、②组无统计学意义(P>0.05),而③④组〉①组(P<0.05),③④组>②组(P<0.05),有统计学意义。5.24小时尿蛋白定量：③④组〉②组(P<0.05),②组〉①组(P<0.05),均有统计学意义。6.CKD5期血液透析组与血透前、血透后PTX3参数无明显变化(P>；0.05)无统计学意义。结论：CKD患者体内都存在炎症状态，PTX3、hs-CRP、TNFa均高于健康人。与CRP相比，CKD患者的肾功能、尿蛋白与PTX3关系更为密切。PTX3与CKD患者的GFR呈直线负相关，与24小时尿蛋白定量呈直线正相关。【关键词】慢性肾脏病血浆五聚素3(PTX3)超敏C反应蛋白(hs-CRP)肿瘤坏死因子(TNFa)24小时尿蛋白定量血液透析【中图分类号】R586【文献标识码】A【文章编号】2095-1752(2013)05-0117-03[Abstract]Objective：ToinvestigatetherelationsbetweenplasmalevelsofPentraxin3andglomerularfiltrationrate(GFR),24-hourproteinuriainpatientswithchronickidneydisease.Methods：120patientswithchronickidneydiseasedividedinto4groups,30patientspergroup:①Stage3chronickidneydisease；②Stage4chronickidneydisease；©Stage5chronickidneydiseasewithouthemodialysis；④Stage5chronickidneydiseasewithhemodialysis；and30heathyincontrolgroup.BloodUreaNitrogen,SerumCreatinine,24-hourproteinuriawerestudied.GFRwascalculatedwithsimplifiedMDRDformula,PlasmaPentraxin3(PTX3),high-sensitiveC-reactiveprotein(hs-CRP)andTumornecrosisfactor-alpha(TNFa)weredeterminedbyRIA.Results:1.PlasmaPTX3^hs-CRP、TNFawereatsignificantlyhigherlevelsinallfourchronickidneydiseasegroupsthanthoseincontrolgroup(P<0.05).2.PTX3levelrosewithGFRlevelfallen:group①<group②<group③④(P<0.01).3.hs-CRPlevelsofallfourgroupsrosewithGFRlevelfallen,hadnostatisticsign讦icance.4.TNFalevelsofallfourgroupsrosewithGFRlevelfallen,group®,®hadnostatisticsignifiesnce(P>0.05),group③，④>group①(P<0.05)andgroup③，④>group(2)(P<0.05)hadstatisticsignificanee.5.24-hourproteinuria:group③‘④>group②(P<0.05)andgroup②>group①(P<0.05)hadstatisticsignificance.6.PTX3levelhadnoconsiderablechangebetweenbeforehemodialysisandafterhemodialysisingroup⑤(P>0.05),hadnostatisticsignificanee.Conclusion：Chronicinflammationwasexistedinpatientswithchronickidneydisease,PlasmaPTX3>hs-CRP、TNFawereatsignificantlyhigherlevelsinchronickidneydiseasethanthoseincontrolgroup・ComparingwithCRP,PlasmaPTX3hasacloserrelationshiptoGFRandproteinuria」tpositivelylinearcorrelateswithGFRandnegativelylinearcorrelateswith24-hourproteinuria.【Keywords]chronickidneydiseasePentraxin3high-sensitiveC-reactiveproteinTumornecrosisfactor-α24-hourproteinuriaHemodialysis慢性肾脏病(CKD)已成为全球性的公共卫生健康问题。它的发病率呈逐年上升趋势。CKD早期患病率是肾衰竭患病率的100倍。近年来的研究证明，慢性肾脏病尤其是终末期患者中普遍存在微炎症状态，而且微炎症状态会加...
