血液透析对慢性肾脏病凝血及炎症的影响

摘要

目的：探讨慢性肾脏病（CKD）5期患者透析与非透析炎症、凝血和纤溶指标的变化，分析血液透析对凝血及炎症的影响。方法选取2013-01～2014-12泸州医学院附属医院肾脏内科收治的93例CKD患者并检测相关凝血及炎症指标。结果与正常对照组35例相比，CKD5期患者57例凝血功能及炎症反应均随着肾小球滤过的下降而逐渐加重，差异有统计学意义。 CKD5期透析组40例与非透析组17例相比，血清纤维蛋白原（ Fg）有所升高，C反应蛋白（ CRP）有所下降，差异有统计学意义（ P＜0.05）；行直线相关分析CRP与Fg、D-D显著相关，呈正相关。结论 CKD5期患者可能存在高凝且继发纤溶亢进的状态，血液透析可能加剧这种紊乱，CKD5期患者高凝状态与炎症密切相关，CRP可能是其危险因素。%Objective To study the effects of hemodialysis on the inflammation and coagulation change in the CKD5 patients.Methods The CKD5 patients were chosen in the Affiliated Hospital of Luzhou Medical College from January 2013 to December 2014 and their coagulation and inflammatory markers were detected .Results Com-pared with those in the control group(n=35), CKD5 of blood coagulation and inflammation in the CKD5 group(n=57) were significantly increased gradually with the decline in glomerular filtration .Fg was significantly increased and CRP significantly decreased in the dialysis CKD5 group(n=40) than those in the non-dialysis group(n=17)(P<0.05 ) .Univariate correlation analysis showed that CRP was significantly positively correlated with Fg and D-D.Con-clusion CKD5 patients may have a hypercoagulable state and secondary fibrinolysis .Hemodialysis may aggravate these disorders .The hypercoagulable state in CKD 5 patients is closely related to inflammation and CRP may be the risk factor .