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目的探讨维持性血液透析(MHD)患者代谢性酸中毒(MA)与微炎症状况的关系。方法选择44例血液透析患者,采血测pH﹑HCO3-﹑BUN、Scr、总蛋白﹑白蛋白﹑前白蛋白﹑血常规﹑电解质﹑iPTH等并计算eKT/V。同时检测各患者的Hs-CRP。将患者按透前HCO3-分为高HCO3-组(HCO3-≥20mmol/l)和低HCO3-组(HCO3-<20mmol/l)。随访3年后观察pH﹑HCO3-﹑BUN﹑Scr﹑总蛋白﹑白蛋白﹑前白蛋白﹑血常规﹑电解质﹑iPTH等并计算eKT/V。同时随访各患者的Hs-CRP。结果入选时两组间RBC﹑BUN﹑血钙﹑血磷等差异显著(P<0.05),Hs-CRP无统计学意义。随访3年后,两组间除了RBC﹑BUN﹑血钙﹑血磷等差异显著(P<0.05),Hs-CRP出现统计学差异(P<0.05)。结论长期的代谢性酸中毒可能影响维持性血液透析患者的微炎症状态。
Objective To investigate the relationship between metabolic acidosis (MA) and micro-inflammation in patients with maintenance hemodialysis (MHD). Methods Forty - four hemodialysis patients were enrolled in this study. Blood samples were taken for measurement of pH, HCO3 -, BUN, Scr, total protein, albumin, prealbumin, blood routine, electrolytes and iPTH, and eKT / V was calculated. Hs-CRP was also tested in each patient. The patients were divided into high HCO3-group (HCO3-≥20mmol / l) and low-HCO3- group (HCO3- <20mmol / l) according to the prior HCO3-. After 3 years of follow-up, observe the pH, HCO3-, BUN, Scr, total protein, albumin, prealbumin, blood routine, electrolytes, iPTH, etc. and calculate eKT / V. Hs-CRP was also followed up in all patients. Results There were significant differences in RBC, BUN, serum calcium and phosphorus between the two groups (P <0.05) at the time of enrollment, but there was no significant difference in Hs-CRP between the two groups. After 3 years of follow-up, there was significant difference (P <0.05) between Hs-CRP and RBC ﹑ BUN ﹑ calcium and phosphorus in the two groups (P <0.05). Conclusion Long-term metabolic acidosis may affect micro-inflammatory status in maintenance hemodialysis patients.