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目的通过研究尿毒症患者超敏C反应蛋白(hs-CRP)、IL-6、IL-10和凝血指标变化,探讨凝血功能变化与尿毒症患者机体微炎症的关系。方法选取26例尿毒症患者和20例健康体检者,空腹取血,测定其血清中hs-CRP、IL-6、IL-10水平和血浆凝血指标,对测定结果进行统计、分析和比较。结果尿毒症患者组血清hs-CRP、IL-6水平明显高于对照组,而IL-10水平则明显低于对照组(22.17±6.25),差异均有统计学意义(P<0.01)。在凝血功能指标中,尿毒症组PT略高于对照组,而APTT则略低于对照组,但其差异并无统计学意义(P>0.05);FIB水平和D-二聚体水平则高于对照组,差异均有统计学意义(P<0.01)。通过相关性分析表明,尿毒症组FIB水平与hs-CRP和IL-6水平呈正相关,与IL-10水平呈负相关;D-二聚体水平与hs-CRP和IL-6水平呈正相关,与IL-10水平呈负相关;而PT、APTT与hs-CRP、IL-6和IL-10水平则无相关性。结论尿毒症患者体内存在着高凝状态,这种状况与患者体内存在的微炎症有关。
Objective To investigate the relationship between coagulation changes and micro-inflammation in uremic patients by studying the changes of hs-CRP, IL-6, IL-10 and coagulation indexes in patients with uremia. Methods Twenty-six uremic patients and 20 healthy volunteers were selected for fasting blood sampling. The levels of serum hs-CRP, IL-6, IL-10 and plasma coagulation indexes were determined. The results were statistically analyzed, compared and analyzed. Results The serum levels of hs-CRP and IL-6 in patients with uremia were significantly higher than those in the control group, while the levels of IL-10 in the patients with uremia were significantly lower than those in the control group (22.17 ± 6.25) (P <0.01). Among coagulation indexes, PT in uremia group was slightly higher than that in control group, while APTT was slightly lower than that in control group, but there was no significant difference (P> 0.05); FIB level and D-dimer level were higher In the control group, the differences were statistically significant (P <0.01). Correlation analysis showed that the levels of FIB in uremia group were positively correlated with the levels of hs-CRP and IL-6 and negatively correlated with IL-10 levels. The levels of D-dimer were positively correlated with the levels of hs-CRP and IL-6, And negatively correlated with the level of IL-10, while there was no correlation between PT, APTT and hs-CRP, IL-6 and IL-10 levels. Conclusion There is a hypercoagulable state in uremic patients, which is related to the presence of micro-inflammation in patients.