腹膜透析患者血尿酸和炎症因子的水平及临床意义

摘要

目的 探讨维持性腹膜透析患者血尿酸和炎症因子的水平及临床意义.方法 根据血尿酸水平,将75例行维持性腹膜透析的慢性肾脏病5期患者分为高尿酸组(A组,42例)和尿酸正常组(B组,33例),检测两组治疗前后TNF、IL-6、IL-8、CRP和血尿酸水平的变化.结果 与治疗前相比,A组治疗后血尿酸、IL-6、IL-8、CRP和TNF水平均降低(P＜0.05),B组治疗后IL-6、IL-8和CRP水平降低(P＜0.05).与B组相比,A组治疗后血尿酸、IL-6、IL-8、CRP和TNF水平下降程度更加明显[(43.2±34.2)μmol/L vs.(0.7±0.3)μmol/L、(14.0±3.3)ng/L vs.(2.6±2.5)ng/L、(14.1±3.8)ng/L vs.(8.2±2.9)ng/L、(25.0±7.8)ng/L vs.(15.7±5.5)ng/L和(28.3±8.6)ng/L vs.(15.4±5.2)ng/L](P＜0.05).Pearson相关分析显示,血尿酸与IL-6、IL-8、TNF和CRP均呈正相关(r=0.482、0.481、0.382和0.488,P＜0.05).结论 腹膜透析可有效改善慢性肾脏病5期患者的高尿酸血症、减少炎症因子水平,并且血尿酸与炎症因子水平密切相关.%Objective To investigate the levels and clinical significance of blood uric acid (BUA) and inflammatory factors in the patients with peritoneal dialysis.Methods According to the level of BUA, 75 patients with 5 stage of chronic kidney diseases accepted maintenance peritoneal dialysis were divided into two groups of A (high level of BUA, 42 cases) and B (normal level of BUA, 33 cases).The changes of TNF, IL-6, IL-8, CRP and BUA were detected before and after treatment in both groups.Results Compared with before, the levels of TNF, IL-6, IL-8, CRP and BUA were significantly decreased after treatment in group A (P＜0.05), which of IL-6, IL-8 and CRP were decreased in group B (P＜0.05).Compared with group B, the decreases of BUA, IL-6, IL-8, CRP and TNF after treatment were more obvious in group A [ (43.2±34.2) μmol/L vs. (0.7±0.3) μmol/L, (14.0±3.3) ng/L vs. (2.6±2.5) ng/L, (14.1±3.8) ng/L vs. (8.2±2.9) ng/L, (25.0±7.8) ng/L vs. (15.7±5.5) ng/L and (28.3±8.6) ng/L vs. (15.4±5.2) ng/L] (P＜0.05).Pearson analysis showed that BUA was positively correlated with IL-6, IL-8, TNF and CRP (r=0.482, 0.481, 0.382 and 0.488, P＜0.05).Conclusion Peritoneal dialysis can effectively improve hyperuricemia and reduce the levels of inflammatory factors in the patients with 5 stage of chronic kidney diseases and BUA is closely related to the levels of inflammatory factors.