Study On The Relationship Between Stage 3-5 Patients Of Chronic Kidney Disease In Micro Inflammation Status And The Quality Of Life

Objective:Preliminarily clear C-reactive protein,interleukin-6,leptin,adiponectin expression and quality of life in CKD3-5 stage patients,to explore the relationship and discipline between C-reactive protein,interleukin-6,leptin,adiponectin and laboratory index,quality of life in CKD3-5 patients with micro-inflammation.Methods:Firstly,to select patients from March 2016 to February 2017 in Affiliated Hospital of Henan University of traditional Chinese medicine,Chinese medicine hospital in Zhengzhou City,Zhengzhou City Seventh People's Hospital and Henan Traditional Chinese Medicine Hospital,including 337 cases.According to there C-reactive protein level,divided them into micro inflammation state group and no micro inflammation state group.Secondly,all cases must be diagnosed with chronic kidney disease and accord with standards for period division.All patients stay overnight fasting for 8-10h,then draw blood from elbow venous at 6-7 clock in the early morning.Hemodialysis patients draw blood in predialysis.On the same day some of the blood were tested for hemoglobin?Hb?,hematocrit?Hct?,urea nitrogen?BUN?,serum creatinine?Scr?,uric acid?UA?,Cystatin C?Cysc?,total cholesterol?CHO?,triglyceride?TG?,serum albumin?Alb?,parathyroid hormone?i PTH?,calcium?Ca?,phosphorus?P?by the First Affiliated Hospital of Henan TCM University.The rest of the blood stand for 30min and immediately Separate serum,then collected in-70?refrigerator for test.Thirdly,detecting the level of cytokines CRP,IL-6,Lep,ADPN by enzyme linked immunosorbent assay?ELISA?.Fourthly,using uniform kidney disease quality of life scale 1.3(KDQOL-SF^TM1.3)version Chinese to collect information.Then score quality of life according to the method provided by Ron D.Hays,Joel D,Kallich,Donna L,Mapes,et al.At the same time analyze the correlation between CRP,IL-6,Lep,ADPN and the main laboratory indicators and quality of life.Results:?1?General situation analysis:In the study of 337 subjects,patients with micro inflammatory state are 165?49%?;without micro inflammatory state are 172?51%?.Age,weight,sex and the primary disease between the two groups is no statistical difference?P>0.05?.?2?The main laboratory index analysis:Lep and IL-6,ADPN,CRP is positively correlated,ADPN is positively associated with CRP?P<0.05?;CRP is negativelycorrelatedwithHb,Hctandpositivelyassociatedwith BUN,Scr,Cysc,PTH,Lep and Hb,Hct,Alb are negatively correlated and positively associated with Scr,PTH,ADPN is negatively correlated with BMI and positively related withScr,Cysc,P,PTH,thedifferencearestatisticallysignificant?P<0.05?;Micro inflammation group's Lep,ADPN level is higher than the non-micro inflammation group?P<0.05?;CRP level in CKD 3 phase is lower than those of CKD 4 period and 5period?P<0.05?,ADPN level in CKD stage 3 and 4 is lower than those of CKD 5period?P<0.05?,CKD 3 stage Lep level is lower than 5 stage?P<0.05?;Dialysis patients'CRP level is higher than that of non dialysis patients,the difference was statistically significant?P<0.05?.?3?The correlation between Micro inflammation state and quality of life:337 subjects get lower score in the function of sex?15.53+28.46?,nephrotic burden?28.75+21.27?,general health?34.72+16.19?and the working condition?35.31+37.19?four dimensions,and the highest score in the dialysis staff encouraged field?80.70+16.76?.On the whole,physiological health score?50.71+13.97?is lower than mental health score?56.04+7.53?;the score of function of sex in microinflammatory group is higher than non microinflammatory group?P<0.05?and SF-36 health condition,general health,cognitive function,symptoms and discomfort,sleep and physiological health score is lower than non microinflammatory group?P<0.05?.Under micro inflammation state,CRP and general health,symptoms and discomfort and physiological health score is negatively correlated?P<0.05?,IL-6 and the quality of social interaction is negatively correlated?P<0.05?,Lep and symptoms and discomfort were negative Correlation?P<0.05?.Conclusion:1.There are 49%patients with micro inflammatory state in patients with chronic kidney disease in 3-5 stage,and CRP,Lep,ANPN level is positively associated with the phase of CKD.CRP level in dialysis patients is higher than nondialysis patients.2.Leptin,adiponectin level in patients with micro inflammationis is generally high and are positively associated with CRP;high leptin,adiponectin and high microinflammationislevelmayworsentherenalfunction,enhance parathyroidism,malnutrition.3.The physiological effects of chronic kidney disease may be more significant than the psychological impact;micro inflammation has great influence on the quality of life in patients with chronic kidney disease,mainly reflecting in general health,cognitive function,symptoms and discomfort,sleep and physiological health score is lower than non microinflammatory group.In patients with chronic kidney disease,the level of micro inflammatory factor is higher,the overall level of health and social quality is lower,and the symptoms and not fitness is more obvious;leptin levels in patients with chronic kidney disease is higer,its symptoms and discomfort is more obvious.