| 133 | 15 | 14 |
| 下载次数 | 被引频次 | 阅读次数 |
目的:分析糖尿病肾病血液透析患者血清氨甲酰血红蛋白、糖化血红蛋白含量及其临床价值。方法:将2012年8月~2015年11月在本院进行血液透析治疗的糖尿病肾病患者84例作为透析组对象,取同期在本院接受治疗的糖尿病肾病非透析患者76例作为非透析组,另取同一时间段在本院进行健康体检的不伴有糖尿病及肾功能异常的人群88例作为健康对照组。测定3组患者的血清氨甲酰血红蛋白、糖化血红蛋白含量,血清营养、透析充分性及病情严重程度相关指标。结果:透析组患者的血清CarHb、HbA1c含量低于非透析组(均P<0.05);透析组患者的BSF、TSF、MAMC、AMA值高于非透析组患者(均P<0.05);透析组患者的血清iPTH、β2-MG、PTX3、OPN水平低于非透析组患者,Kt/V水平高于非透析组患者(均P<0.05);透析组患者的sTfR、IGF-1、NF-κBp65值低于非透析组患者,APN、Hepcidin、GH值高于非透析组患者(均P<0.05);糖尿病肾病透析组患者的血清CarHb、HbA1c水平与iPTH、β2-MG、PTX3、OPN、sTfR、IGF-1、NF-κBp65呈正相关,与BSF、TSF、MAMC、AMA、Kt/V、APN、Hepcidin、GH呈负相关(均P<0.05)。结论:糖尿病肾病血液透析患者血清氨甲酰血红蛋白、糖化血红蛋白含量可以作为判断病情严重程度、透析有效性等的直观指标,在指导疾病治疗方面也有积极意义。
Abstract：Objective:To analyze the serum carbaminohemoglobin and glycated hemoglobin contents in diabetic nephropathy patients with hemodialysis as well as their clinical value.Methods:A total of 84 cases of diabetic nephropathy who received hemodialysis treatment in our hospital from August 2012 to November 2015 were selected as dialysis group,76 cases of diabetic nephropathy without hemodialysis who received treatment in our hospital during the same period were selected as non-dialysis group,and 88 cases without diabetes or renal dysfunction who received physical examination in our hospital during the same period were selected as healthy control group.Serum carbaminohemoglobin and glycated hemoglobin contents as well as serum nutrition,dialysis adequacy and disease severity-related indicators of three groups were detected.Results:Serum CarHb and HbA1 ccontents of dialysis group were lower than those of non-dialysis group(P<0.05);BSF,TSF,MAMC and AMA values of dialysis group were higher than those of non-dialysis group(P<0.05);serum iPTH,β2-MG,PTX3 and OPN levels of dialysis group were lower than those of non-dialysis group while Kt/V level was higher than that of non-dialysis group(P<0.05);sTfR,IGF-1and NF-κBp65values of dialysis group were lower than those of non-dialysis group while APN,Hepcidin and GH values were higher than those of non-dialysis group(P<0.05);serum CarHb and HbA1 clevels of dialysis group were positively correlated with iPTH,β2-MG,PTX3,OPN,sTfR,IGF-1and NF-κBp65,and negatively correlated with BSF,TSF,MAMC,AMA,Kt/V,APN,Hepcidin and GH(P<0.05).Conclusions:Serum carbaminohemoglobin and glycated hemoglobin contents in diabetic nephropathy patients with hemodialysis are direct indexes to judge disease severity,dialysis effectiveness,etc,and have positive significance in guiding the treatment of disease.
1 Watarai R,Aoyama T,Kamata M,et al.Heparin-induced thrombocytopenia with pseudo-pulmonary embolism in a patient who was newly introduced to hemodialysis treatment[J].Nihon Jinzo Gakkai Shi,2015,57(7):1248-1252.
2 Vega-Diaz N,Gonzalez-Cabrera F,Marrero-Robayna S,et al.Renal Replacement Therapy:Purifying Efficiency of Automated Peritoneal Dialysis in Diabeticversus Non-Diabetic Patients[J].J Clin Med,2015,4(7):1518-1535.
3 Cikrikcioglu MA,Ozdemir AA,Sekin Y,et al.Association of calcium antagonist use with lower hemoglobin levels in hemodialysis patients[J].Minerva Urol Nefrol,2015,67(3):187-196.
4 Fukami K,Shibata R,Nakayama H,et al.Serum albumin-adjusted glycated albumin reflects glycemic excursion in diabetic patients with severe chronic kidney disease not treated with dialysis[J].J Diabetes Complications,2015,29(7):913-917.
5 李爽,杜娟,胡曼丽.糖尿病肾病维持性血液透析患者血清氨基酸变化[J].中国实验诊断学,2015,19(10):1766-1768.
6 Kim SH,Lee KA,Jin HY,et al.The Relationship between Anemia and the Initiation of Dialysis in Patients with Type 2Diabetic Nephropathy[J].Diabetes Metab J,2015,39(3):240-246.
7 Tan J,Manley P,Gamble G,et al.Long-term effectiveness of a community-based model of care in Māori and Pacific patients with type 2diabetes and chronic kidney disease:a 4-year follow up of the DElay Future End StageNephropathy due to Diabetes(DEFEND)study[J].Intern Med J,2015,45(8):843-849.
8 Kozuma K,Otsuka M,Ikari Y,et al.Clinical and angiographic outcomes of paclitaxel-eluting coronary stent implantation in hemodialysispatients:A prospective multicenter registry:The OUCH-TL study(outcome in hemodialysis of TAXUS Liberte)[J].J Cardiol,2015,66(6):502-508.
9 李沛霖,杨锐,周勇,等.糖尿病肾病患者糖化血清蛋白测定的意义[J].南方医科大学学报,2011,31(6):1093-1095.
10 Noguchi H,Kitada H,Kaku K,et al.Outcome of renal transplantation in patients with type 2diabetic nephropathy:a singlecenter experience[J].Transplant Proc,2015,47(3):608-611.
11 Georgiadis GS,Argyriou C,Antoniou GA,et al.Upper limb vascular calcification score as a predictor of mortality in diabetic hemodialysis patients[J].J Vasc Surg,2015,61(6):1529-1537.
12 Suzuki H,Kikuta T,Inoue T,et al.Time to re-evaluate effects of renin-angiotensin system inhibitors on renal and cardiovascular outcomes in diabetic nephropathy[J].World J Nephrol,2015,4(1):118-126.
13 周青霞.血清糖化血红蛋白、C反应蛋白及微量白蛋白水平与老年糖尿病肾病患者肾微血管病变的相关性[J].中国老年学杂志,2015,35(9):900-902.
14 Tobino K,Muso E,Iwasaki Y,et al.Gender-and disease-specific urinary thioredoxin in chronic kidney disease patients with or without type 2diabetic nephropathy[J].Nephrology(Carlton),2015,20(5):368-374.PMID:25615414.
15 Ozyalvacli ME,Uyeturk U,Halicioglu S,et al.Spontaneous renal parenchymal hematoma associated with clopidogrel in a patient with diabetic nephropathy[J].Ann Pharmacother,2015,49 (2):260-261.PMID:25583941.
基本信息:
DOI：10.13210/j.cnki.jhmu.20160302.007
中图分类号:R587.2
引用信息:
[1]宋明爱,王璐.糖尿病肾病血液透析患者血清氨甲酰血红蛋白、糖化血红蛋白含量检测及其临床价值评估[J].海南医学院学报,2016,22(12):1296-1299.DOI:10.13210/j.cnki.jhmu.20160302.007.
基金信息:
陕西省计生委卫生科研项目(2014D30)~~
2016-03-02
2016-03-02
2016-03-02