本文關(guān)鍵詞：不同類型血管通路對維持性血液透析患者微炎癥狀態(tài)的影響　出處：《廣西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 維持性血液透析 血管通路 C反應(yīng)蛋白

【摘要】：目的:探討不同血管通路對維持性血液透析(MHD)患者C-反應(yīng)蛋白(CRP)水平以及微炎癥狀態(tài)的影響。方法:采用橫斷面研究,共納入220例MHD患者。根據(jù)MHD患者血管通路分為自體動靜脈內(nèi)瘺(AVF)組及帶隧道帶滌綸套導(dǎo)管(TCC)組。其中AVF組138例,TCC組83例。AVF組男性93例,女性45例,平均年齡為(51.7±14.2)歲。TCC組男性54例,女性28例,平均年齡(60.4±15.4)。通過檢測血清超敏C反應(yīng)蛋白(hs-CRP)、血清白蛋白、總鈣、磷、全段甲狀旁腺激素、透析前后尿素氮、肌酐、尿酸、血清鐵蛋白、轉(zhuǎn)鐵蛋白飽和度,并計算鈣磷乘積、尿素清除指數(shù)(Kt/v)、尿素下降率(URR),分析不同血管通路對血清hs-CRP的影響。結(jié)果:TCC組hs-CRP明顯高于AVF組,兩組間hs-CRP差異有統(tǒng)計學(xué)意義(P0.05)。兩組年齡、白蛋白、肌酐差異有統(tǒng)計學(xué)意義(P0.05)。白蛋白、轉(zhuǎn)鐵蛋白飽和度與hs-CRP呈負相關(guān),有統(tǒng)計學(xué)意義(r=-0.182,r=-0.187,P=0.007,P=0.005)。尿酸與hs-CRP相關(guān)性有統(tǒng)計學(xué)意義,呈正相關(guān)(r=0.188,P=0.005)。多元逐步回歸分析顯示血管通路是hs-CRP的獨立影響因素(F=26.238,P0.001),帶隧道帶滌綸套導(dǎo)管是hs-CRP水平升高的獨立危險因素。結(jié)論:不同血管通路可以影響維持性血液透析患者CRP水平,帶隧道帶滌綸套導(dǎo)管可能是維持性血液透析患者發(fā)生微炎癥狀態(tài)的原因之一。
[Abstract]:Objective: to investigate the effects of different vascular pathways on the level of C-reactive protein (CRP) and microinflammation in patients with maintenance hemodialysis (MHD). Two hundred and twenty patients with MHD were divided into two groups according to the vascular pathway of MHD: autogenous arteriovenous fistula (AVF) group and MHD group (AVF group). There were 93 males and 45 females in TCC group. The average age was 51.7 鹵14.2 years old. There were 54 males and 28 females in TCC group. The mean age was 60.4 鹵15.40.The serum hypersensitive C-reactive protein hs-CRP, serum albumin, total calcium, phosphorus, total parathyroid hormone, urea nitrogen and creatinine were detected before and after dialysis. Uric acid, serum ferritin, transferrin saturation, calcium and phosphorus product, urea clearance index (KT / vN), urea decline rate (URR). The effects of different vascular pathways on serum hs-CRP were analyzed. Results the hs-CRP of AVF group was significantly higher than that of AVF group. The difference of hs-CRP between the two groups was statistically significant (P 0.05). There were significant differences in age, albumin and creatinine between the two groups (P 0.05). There was a negative correlation between transferrin saturation and hs-CRP. The correlation between uric acid and hs-CRP was statistically significant, and there was a positive correlation between uric acid and hs-CRP. Multiple stepwise regression analysis showed that vascular pathway was an independent factor of hs-CRP. Conclusion: different vascular pathways can affect the CRP level of maintenance hemodialysis patients. Tunneling with polyester duct may be one of the causes of microinflammation in maintenance hemodialysis patients.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R692.5

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