血浆内毒素水平与慢性肾脏病及其营养状态的相关性研究
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摘要
目的探讨血浆内毒素水平与慢性肾脏病严重程度及患者营养状态的关系。方法选取80例慢性肾脏病患者,根据肌酐清除率分为非终末期肾病组及终末期肾病组,选取40例健康者作为正常对照组,检测受试者的血浆内毒素、血常规、血清肌酐、白蛋白及总胆固醇、甘油三酯水平,对比各组血浆内毒素水平差异,并对慢性肾脏病患者血浆内毒素水平与血红蛋白、血清白蛋白、总胆固醇、甘油三酯进行水平相关性分析。结果 (1)慢性肾脏病患者的血浆内毒素水平较正常对照组均明显升高,且组间两两比较差异均有统计学意义(P<0.05)。(2)慢性肾脏病各组血浆内毒素与血红蛋白、血白蛋白呈负相关,差异有统计学意义(P<0.05)。结论慢性肾脏病患者存在高内毒素血症,高内毒素水平可能是慢性肾脏病发生发展的影响因素,且可能与慢性肾脏病患者贫血及低蛋白血症相关。
Objective To explore the role of plasmic endotoxin in the development of chronic kidney diseases and the correlation between plasmic endotoxin and the CKD patients' nutritional status. Methods Plasmic endotoxin,hemoglobin,serum albumin,cholesterol total and triglyceride levels were measured and compared in a total of 40 patients with end stage renal diseases and 40 patients with eraly stage renal diseases and 40 healthy volunteers. Results (1) The patients with chronic kidney diseases had higher plasmic endotoxin levels than healthy subjects and the difference was significant(P<0.05). Significant differences were observed in pairwise comparison(P <0.05). (2)Plasmic endotoxin levels levels in CKD patients were negatively correlated with hemoglobin and serum albumin. Conclusion There were certain relationships between plasmic endotoxin and chronic kidney diseases. Endotoxin may play an important role in their procedures,the patients' anemia and hypoproteinemia.
Objective To explore the role of plasmic endotoxin in the development of chronic kidney diseases and the correlation between plasmic endotoxin and the CKD patients' nutritional status. Methods Plasmic endotoxin,hemoglobin,serum albumin,cholesterol total and triglyceride levels were measured and compared in a total of 40 patients with end stage renal diseases and 40 patients with eraly stage renal diseases and 40 healthy volunteers. Results (1) The patients with chronic kidney diseases had higher plasmic endotoxin levels than healthy subjects and the difference was significant(P<0.05). Significant differences were observed in pairwise comparison(P <0.05). (2)Plasmic endotoxin levels levels in CKD patients were negatively correlated with hemoglobin and serum albumin. Conclusion There were certain relationships between plasmic endotoxin and chronic kidney diseases. Endotoxin may play an important role in their procedures,the patients' anemia and hypoproteinemia.
引文
[1]涂卫平,危志强.慢性肾脏病的分期及防治[J].江西医药,2010,45(10):1064-1066.
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[5]Vaziri ND.CKD impairs barrier function and alters microbial flora of the intestine:a major link to inflammation and uremic toxicity[J].Curt Opin Nephrol Hypertens,2012,21(6):587-592.
[6]Wright SD,Ramos RA,Tobias PS,et al.CD14,a receptor for complexes of lipopolysaccharide(LPS)and LPS binding protein;Science[J].New York,NY:1990.249:1431-1433.
[7]Tobias PS,Soldau K,Ulevitch RJ.Identification of a lipid A binding site in the acute phase reactant lipopolysaccharide binding protein[J].J Biological Chemistry,1989,264(18):10867-10871.
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[10]杨朝辉.内毒素与慢性肾脏疾病的关系研究进展[J].中国现代医学杂志,2004,14(9):68-70.
[11]粱莹.内毒素致病机制的研究进展[J].现代医药卫生,2004,20(24):2667-2668.
[12]Zyga S,Christopoulou G,Malliarou M.Malnutritioninflammationatherosclerosis syndrome in patients with endstage renal disease[J].J Ren Care,2011,37(1):12-15.
[2]Zhang L,Wang F,Wang L,et al.Prevalence of chronic kidney disease in China:a cross-sectional survey[J].Lancet,2012,379(9818):815-822.
[3]Lawson JA,Lazarus R,Kelly JJ.Prevalence and prognostic significance of malnutrition in chronic renal insufficiency[J].J Ren Nutr,2001,11(1):16-22.
[4]Hauser AB,AEM Stinghen,SM Goncalves,et al.A gut feel ing on endotoxemia:causes and consequences in chronic kidney disease[J].Nephron C1 in Pract,2011:118:c165-c172.
[5]Vaziri ND.CKD impairs barrier function and alters microbial flora of the intestine:a major link to inflammation and uremic toxicity[J].Curt Opin Nephrol Hypertens,2012,21(6):587-592.
[6]Wright SD,Ramos RA,Tobias PS,et al.CD14,a receptor for complexes of lipopolysaccharide(LPS)and LPS binding protein;Science[J].New York,NY:1990.249:1431-1433.
[7]Tobias PS,Soldau K,Ulevitch RJ.Identification of a lipid A binding site in the acute phase reactant lipopolysaccharide binding protein[J].J Biological Chemistry,1989,264(18):10867-10871.
[8]Tobias PS,Ulevitch RJ.Lipopolysaccharide-binding protein and CD14 in the lipopolysaccharidedependent activation of cells[J].Chest,1994,105(Suppl)(3):48S-50S.
[9]黄建生,余叔侃.抗内毒素治疗研究现状[J].江西医药,2001,36(2):138-140.
[10]杨朝辉.内毒素与慢性肾脏疾病的关系研究进展[J].中国现代医学杂志,2004,14(9):68-70.
[11]粱莹.内毒素致病机制的研究进展[J].现代医药卫生,2004,20(24):2667-2668.
[12]Zyga S,Christopoulou G,Malliarou M.Malnutritioninflammationatherosclerosis syndrome in patients with endstage renal disease[J].J Ren Care,2011,37(1):12-15.