| PurposeTo investigate the maintenance hemodialysis patients with the presence of micro-inflammatory state and its related factors, in order to reduce complications and mortality in MHD patients, improve the quality of life and rate of social return to provide new ideas.MethodsChoose 51 MHD patients with chronic renal failure as MHD group, and collect clinical data of these patients; 29 healthy volunteers as control group. Detection of micro-inflammation Indicators:Serum C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-a (TNF-a) in MHD patients, compared with the control group; detection of serum creatinine (Scr), blood urea nitrogen (BUN), hemoglobin (Hb), transferrin (TRF), serum albumin (ALB), bicarbonate ions (HC03-), Serum parathyroid hormone (pTH) and other related indicators MHD group, make correlation analysis between CRP, IL-6 and TNF-a and the above-mentioned indicators. According to whether taking angiotensin-converting enzyme inhibitorⅡ/angiotensinⅡreceptor 1 antagonist (ACEI/ARB) drug, divided the MHD group into taking ACEI/ARB and non-taking, select 15 cases who taking ACEI/ARB drugs more than three months as treatment group, compared with 14 patients who non-taking as control group.There was no significant difference between the two groups in age, gender, dialysis age Compared whether CRP, IL-6, TNF-a. have differences between these two groups.Results1,Compared with healthy individuals, serum CRP, IL-6, TNF-a were significantly increased in MHD group, there are statistically significant [(respectively (8.88±8.46) mg/L vs (0.8±0.2) mg/L, P<0.01; (10.57±5.25) pg/ml vs (1.70±0.43) pg/ml, P<0.01; (30.55±12.84) pg/ml vs (11.36±3.14) pg/ml, P<0.01)].2,Correlation analysis showed that, serum CRP significantly positively correlated with IL-6, TNF-a, BUN, Scr, PTH,dialysis age (respectively r=0.526, P <0.01; r= 0.511, P<0.01; r=0.279, P<0.05; r=0.287, P<0.05;r=0.341, P<0.05;r= 0.298, P<0.05), and significantly negatively correlated with nutritional status indicators such as serum ALB, TRF (P<0.05, r=-0.573; P<0.01, r=-0.46),negatively correlated with HCO3-(P<0.01.r=-0.479), no significant correlation with Hb, age of patients in MHD group.3,In MHD patients, selected 15 cases who taking ACEI/ARB drugs over 3-month as treatment group,14 cases who not taking were as control group, then compared. There was no significant difference between the two groups in age, gender, and dialysis age. Compared with the control group, serum CRP, IL-6, TNF-a were significantly reduced in the treatment group, there are statistically significant [respectively (0.55±0.32) mg/L vs (10.07±9.34) mg/L;(9.66±4.53) pg/ml vs (14.24±6.69) pg/ml;(38.35±16.46) pg/ml vs (26.36±11.25) pg/ml, P<0.05].Conclusion1,The level of serum CRP, IL-6, TNF-a increase significantly suggest the existence of micro-inflammatory state in maintenance hemodialysis patients.2,Serum CRP can be used as a good marker of micro-inflammatory state in maintenance hemodialysis patients, and may be correlated with dialysis age, Serum PTH,Serum HCO3-3,The presence of micro-inflammatory state in MHD patients have an important impact on their nutritional status.4,ACEI/ARB drugs can improve the micro-inflammatory state in MHD patients. |
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