目的：分析腹膜透析患者的C反应蛋白(C-reactive protein,CRP)与铁代谢相关指标间的相关性,探讨微炎症状态(microinflammatory state,MS)对腹膜透析患者铁代谢状态评估的影响。方法选择我院规律随访的持续性非卧床腹膜透析(continuous ambulatory peritoneal dialysis, CAPD)患者79例,记录患者年龄、性别、透析时间、收缩压、舒张压,计算尿素清除指数(Kt/V),检测血红蛋白、CRP、血清铁(serum iron,SI)、转铁蛋白饱和度(transferrin saturation,TSAT)、血清铁蛋白(serum ferritin,SF)、血白蛋白、血肌酐、尿素氮。根据患者的 CRP 水平分为 A组(CRP≤8 mg/L)和B组(CRP>8 mg/L)；并根据患者的 SF水平分为 C 组(SF<500μg/L)和 D 组(SF≥500μg/L),应用t检验分别比较 A 组与 B 组间年龄、性别、透析时间、收缩压、舒张压、Kt/V 值、血红蛋白、SI、TSAT、SF、血白蛋白、血肌酐、尿素氮等指标的差异,以及 C 组与 D 组间年龄、性别、透析时间、收缩压、舒张压、Kt/V值、血红蛋白、CRP、SI、TSAT、血白蛋白、血肌酐、尿素氮等指标的差异。采用Pear-son相关分析,分析患者的 CRP 水平与 SI、TSAT、SF和收缩压、舒张压水平的相关性。结果①与A组比较,B组患者的 SF水平显著升高(t=2.976,P<0.01),SI、TSAT、收缩压和舒张压水平降低(分别为t=3.743,P<0.01；t=2.420,P=0.018；t=2.181,P=0.032；t=2.328,P=0.023),血红蛋白水平(t=0.680,P=0.498)差异无统计学意义。②C 组与 D 组间比较年龄、性别、透析时间、收缩压、舒张压、Kt/V值、血红蛋白、CRP、SI、TSAT、血白蛋白、血肌酐、尿素氮差异均无统计学意义(P>0.05)。③CRP与 SF呈正相关(r=0.460,P<0.01),与 SI呈负相关(r=-0.350,P=0.002)。结论腹膜透析患者的铁代谢指标受到MS的影响,需要联合检测SI、TSAT、SF以及CRP水平以正确评估患者的铁代谢状态。%Objective To analyze the correlation between C-reactive protein (CRP)and indica-tors of iron metabolism,and explore the effect of microinflammatory state on iron metabolism in peri-toneal dialysis patients.Methods Seventy-nine patients undergoing continuous ambulatory peritoneal dialysis (CAPD)from our hospital were enrolled in the study.The data of age,sex,PD duration, systolic blood pressure (SBP),diastolic blood pressure (DBP),Kt/V,hemoglobin,CRP,serum iron (SI),transferrin saturation (TSAT),serum ferritin (SF),serum albumin,serum creatinine,and u-rea nitrogen were collected.The patients were divided into group A (CRP≤8 mg/L)and group B (CRP>8 mg/L)according to the levels of CRP.The patients were also divided into group C (SF<500μg/L)and group D (SF≥500μg/L)according to the levels of SF.Comparison of data between groups (A and B,or C and D)was performed using the Student t-test for continuous parametric data. The correlation between CRP and SI,TSAT,SF,SBP or DBP was analyzed by Pearson correlation a-nalysis.Results (1 )As compared with group A,the levels of SF were significantly increased (t=-2.976,P<0.01),and those of SI,TSAT,SBP and DBP were significantly decreased in group B (t=3.743,P<0.01;t=2.420,P=0.018;t=2.181,P=0.032;t=2.328,P=0.023 respectively). There was no significant difference in hemoglobin between group A and group B (t=0.680,P=0.498).(2)No significant difference was found in the clinical data between group C and group D such as age,sex,PD duration,SBP,DBP,Kt/V,hemoglobin,CRP,SI,TSAT,serum albumin,serum creatinine,and urea nitrogen.(3)Pearson correlation analysis revealed that CRP had a positive corre-lation with SF (r=0.460,P<0.01)and a negative correlation with SI (r=-0.350,P=0.002). Conclusions The indicators of iron metabolism are constantly affected by microinflammatory state in CAPD patients.Therefore,the combined tests of SI,TSAT,SF and CRP may favor the correct as-sessment of iron metabolism state.
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