|
|
|
| Clinical significance and changes of microinflammatory factor, calcium and phosphorus metabolism levels in patients with chronic kidney disease and cardiac insufficiency#br# |
| SHEN Yuxin WANG Yangyang DENG Wenyan ZHANG Jing▲ |
| Department of Intrarenal Rheumatology, the Fourth Affiliated Hospital of Anhui Medical University, Anhui Province, Hefei 230001, China |
|
|
|
Abstract Objective To study the clinical significance and changes of microinflammatory factor, calcium and phosphorus metabolism levels in patients with chronic kidney disease and cardiac insufficiency, and to provide guidance for clinical research. Methods A total of 85 patients with chronic kidney disease and cardiac insufficiency admitted to the Fourth Affiliated Hospital of Anhui Medical University from March 2018 to March 2020 were selected, according to the estimated glomerular filtration rate level of patients, they were divided into chronic kidney disease stage 1-2 group (14 cases), chronic kidney disease stage 3 group (22 cases), chronic kidney disease stage 4 group (23 cases), and chronic kidney disease stage 5 group (26 cases), and 30 healthy subjects were selected as control group during the same period. Serum fibrinogen (FIB), procalcitonin (PCT), and hypersensitive C-reactive protein (hs-CRP) were detected by enzyme-linked immunosorbent assay (ELISA) and immunoturbidimetry. Blood phosphorus (P), blood calcium (Ca) and parathyroid hormone (PTH) were detected by automatic biochemical analyzer. The correlation between microinflammatory state and calcium and phosphorus metabolism was analyzed. Results The levels of FIB, PCT, and hs-CRP in the groups of chronic kidney disease stage 1-2, 3, 4, and 5 groups were significantly higher than those in the control group, the differences were statistically significant (P ＜ 0.05). The level of PCT in chronic kidney disease stage 4 group was significantly higher than that in the chronic kidney disease stage 1-2 group and 3 group, the levels of PCT and hs-CRP in the chronic kidney disease stage 5 group were significantly higher than those in chronic kidney disease stage 1-2 group, 3 group and 4 group, the differences were statistically significant (P ＜ 0.05). The levels of P and PTH in chronic kidney disease stage 1-2 group, 3 group, 4 group, and 5 group were higher than those in control group, the levels of Ca in chronic kidney disease stage 1-2 group and 3 group were lower than those in control group, and the level of PTH in chronic kidney disease 3 group was significantly higher than those in chronic kidney disease stage 1 group and 2 group. The levels of PTH and Ca in chronic kidney disease stage 4 group were significantly higher than those of chronic kidney disease stage 1-2 group, and 3 group, the levels of P and PTH in chronic kidney disease stage 5 group were higher than those in the chronic kidney disease stage 1-2 group, 3 group, and 4 group, level of Ca in chronic kidney disease stage 5 group was significantly higher than those of chronic kidney disease stage 3 group and 4 group, the differences were statistically significant (P ＜ 0.05). There was significant positive correlation between PCT level and P, PTH level, and significant negative correlation between PCT levels and Ca level (r = 0.614, 0.502, -0.551, P ＜ 0.001). hs-CRP was positively correlated with P and PTH levels, and negatively correlated with Ca level (r = 0.521, 0.518, -0.426, P ＜ 0.001). Conclusion Patients with chronic kidney disease and cardiac insufficiency have a micro-inflammatory state, abnormal calcium, and phosphorus metabolism levels, and their micro-inflammatory state may be related to calcium and phosphorus metabolism.
|
|
|
|
|
|
[1] 徐杨，李普庆，姜国芳，等.骨化三醇联合常规治疗对慢性肾脏病患者肾功能、炎性因子及钙磷代谢的影响[J].现代生物医学进展，2020，20（4）：756-759.
[2] 张宇，陈卫东.慢性肾脏病患者钙磷代谢紊乱的研究进展[J].安徽医学，2017，38（8）：1088-1091.
[3] 韩海燕，路建饶，王新华.肾衰方对CKD4期慢性肾衰患者肾功能及钙磷代谢的影响[J].辽宁中医杂志，2017，44（2）：312-315.
[4] 文丰，李洋，汪升学，等.尿毒清联合常规西药对老年慢性肾脏病患者临床疗效、钙磷代谢及相关因子水平的影响[J].解放军预防医学杂志，2019，37（9）：110-112.
[5] 李婉莎，余毅.慢性肾脏病患者钙磷代谢紊乱及其治疗策略[J].世界临床药物，2018，39（3）：204-210.
[6] 闫奇奇，郝丽，张森.慢性肾脏病患者血清FGF23水平与钙磷代谢及临床相关性[J].安徽医科大学学报，2019， 54（5）：776-780.
[7] 程虹，李颖霞，王小琴，等.慢性肾脏病3～5期患者病情程度与α-Klotho、FGF23及钙、磷相关性研究[J].中国医药导报，2020，552（22）：78-81.
[8] Kellum JA，Lameire N，Aspelin P，et al. Kidney Disease：Improving Global Outcomes. KDIGO Clinical Practice Guideline for Anemia in Chronic Kidney Disease [J]. Kidney International Supplements，2012，4（2）：279-331.
[9] 张桂霞，蒋克国，袁亮，等.3种CKD-EPI方程估算肾小球滤过率的比较[J].安徽医科大学学报，2015（1）：66-69.
[10] 彭燕，张威，郝静，等.慢性肾脏病患者成纤维细胞生长因子23与肾功能及钙磷代谢的关系[J].中华肾脏病杂志，2010，26（2）：81-85.
[11] 帕提古丽·阿斯讨拜，张艳，布合力其·麦麦提，等.慢性肾脏病患者血浆成纤维细胞生长因子23水平与骨矿物质代谢的相关性分析[J].国际泌尿系统杂志，2021， 41（1）：135-138.
[12] 彭燕，张威，郝静，等.慢性肾脏病不同肾功能状态血清FGF23的变化及与钙磷代谢的关系[J].中华内科杂志，2010，49（3）：257-258.
[13] Ishigami J，Taliercio J，I Feldman H，et al. Inflammatory Markers and Incidence of Hospitalization With Infection in Chronic Kidney Disease： The Chronic Renal Insufficiency Cohort Study[J]. Am J Epidemiol，2020，189（5）：433-444.
[14] 李敏侠.慢性肾脏病患者钙磷代谢和骨转换指标变化及其影响因素分析[D].北京：解放军总医院（北京301医院）&军医进修学院，2016.
[15] 牟爱华，赵建明.慢性肾脏病3-5期钙磷代谢达标情况及监测频率调查[J].中国临床研究，2016，29（8）：1087-1089.
[16] 赵雨薇，李长红.慢性肾脏病患者高同型半胱氨酸血症及微炎症与血管内皮损伤的关系[J].齐齐哈尔医学院学报，2019，40（3）：294-296.
[17] 罗佳佳，褚以德，李瑜琳.慢性肾脏病微炎症状态及其与营养不良关系的研究进展[J].山东医药，2016，56（14）：107-109.
[18] 李志红，申强.脂蛋白相关磷脂酶A2与动脉粥样硬化及冠心病关系的研究进展[J].中国当代医药，2020，590（31）：21-25.
[19] 武亚南，陈卫东，刘磊.CKD患者微炎症状态与钙磷代谢的相关性分析[J].齐齐哈尔医学院学报，2018，39（22）：2621-2626.
[20] 吴金庆.慢性肾脏病患者不同分期血清钙、磷、IL-6及hs-CRP相关性研究[D].安徽：安徽医科大学，2015.
[21] 吴岭，白运焕，陈葶，等.慢性肾脏病患者钙磷代谢与心血管疾病的关系分析[J].中华全科医学，2016，14（10）：1677-1679.
[22] 柳诗意，张宁.慢性肾脏病血管钙化中西医治疗进展[J].中国中西医结合杂志，2017，37（10）：1276-1280.
[23] 黄德慧，刘小菊，章磊，等.畲药益肾方治疗慢性肾脏病3期患者微炎症状态的临床研究[J].中国现代医生，2021， 59（19）：144-147.
[24] 郑昌玲，杨可，余彦霖，等.慢性肾脏病患者血清Klotho蛋白水平与炎症因子的相关性分析[J].第三军医大学学报，2016，38（24）：2606-2610.
[25] 梁洁，廖安全，叶昌荣，等.慢性肾脏病患者肠道菌群特征及其与微炎症因子水平的相关性探讨[J].中国医药科学，2021，257（17）：204-206，234.
[26] 施欣辛.慢性肾脏病非透析患者不同时期血清白介素-6和瘦素的变化与中医证型之间的关系[D].成都：成都中医药大学，2017.
[27] 杨爽，刘锋，李淼，等.慢性肾脏病患者微炎症致动脉粥样硬化的机制研究进展[J].中国实验诊断学，2020，24（3）：530-532.
[28] 熊小荣，黄玉麟，李彦黎.多种透析方法联合应用于尿毒症的治疗观察及对患者PTH、25-羟基维生素D水平的影响[J].临床和实验医学杂志，2021，342（14）：1517-1521. |
|
|
|
