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目的通过测定尿毒症血液透析患者C反应蛋白并分析其与脂蛋白(a)的关系,探讨尿毒症的微炎症状态对脂蛋白(a)的影响与动脉粥样硬化的关系。方法监测50例尿毒症血液透析患者C反应蛋白和脂蛋白(a)水平,并与30例正常人比较,分析它们之间的关系。结果尿毒症血液透析组血清C反应蛋白、脂蛋白(a)水平明显高于对照组,差异有统计学意义。尿毒症血液透析患者血清脂蛋白(a)与C反应蛋白呈明显正相关(r值分别为0.627,P<0.01)。结论尿毒症维持性血液透析患者存在微炎症状态,炎症可能与脂蛋白(a)代谢异常密切相关,是尿毒症透析患者高发动脉粥样硬化、心脑血管事件的独立危险因素之一。监测尿毒症维持性血液透析患者脂蛋白(a)与CRP水平的增高,有助于我们及早发现微炎症状态,可降低患者心脑血管事件的发生,降低并发症及死亡率。
Objective To investigate the relationship between lipoprotein (a) and atherosclerosis by measuring the relationship between lipoprotein (a) and C-reactive protein in hemodialysis patients with uremia. Methods The levels of C-reactive protein and lipoprotein (a) in 50 hemodialysis patients with uremia were monitored and compared with 30 healthy controls to analyze their relationship. Results Serum levels of C-reactive protein and lipoprotein (a) in uremic hemodialysis group were significantly higher than those in control group, the difference was statistically significant. Serum lipoprotein (a) was positively correlated with C-reactive protein in uremic hemodialysis patients (r = 0.627, P <0.01). Conclusions The patients with uremic maintenance hemodialysis have micro-inflammatory status. Inflammation may be closely related to the abnormal metabolism of lipoprotein (a), which is one of the independent risk factors for the high incidence of atherosclerosis and cardiovascular and cerebrovascular events in uremic dialysis patients. Monitoring elevated levels of lipoprotein (a) and CRP in maintenance hemodialysis patients with uremia helps us to detect micro-inflammatory conditions early and may reduce cardiovascular and cerebrovascular events and reduce complications and mortality.