| 张文婷,郑娜,焦亮.尿毒症血液透析病人网织红细胞、血清转氨酶水平与预后关系[J].安徽医药,2021,25(7):1437-1441. |
| 尿毒症血液透析病人网织红细胞、血清转氨酶水平与预后关系 |
| Relationships between reticulocyte, serum transaminase levels and prognosis in uremic hemodialysis patients |
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| DOI：10.3969/j.issn.1009-6469.2021.07.040 |
| 中文关键词: 尿毒症 血液透析 网织红细胞 血清转氨酶 |
| 英文关键词: Uremia Hemodialysis Reticulocyte Serum transaminase |
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| 中文摘要: |
| 目的观察尿毒症血液透析病人网织红细胞( RET)、血清转氨酶水平，并探讨二者与尿毒症血液透析预后的关系。方法选取 2015年 6月至 2016年 6月四川省人民医院收治的尿毒症血液透析病人 78例，同时选取同期体检健康者 78例为对照组。采用全自动血液分析仪检测 RET水平，采用酶联免疫吸附( ELISA)法测定病人血清转氨酶水平，采用多功能全自动生化分析仪进行肾功能指标测定，采用彩色多普勒超声心动仪测定研究对象心功能指标，并分析尿毒症血液分析病人 RET、血清转氨酶与心、肾功能指标的相关性。结果与对照组［( 101.48±33.41)μmol/L、(6.49±2.11)mmol/L、(16.43±5.07)mg/L、(112.23±20.31)mL、(37.28±5.43)mL］相比，尿毒症血液透析病人透析前后血肌酐( Scr)［( 186.45±61.38)μmol/L、(138.76±46.81)μmol/L］、血尿素氮(BUN)［( 13.21±4.87)mmol/L、(9.63±3.18)mmol/L］、 β2微球蛋白( β2-MG)［( 29.14±9.23)mg/L、(22.47±6.94)mg/ L］、左室舒张期末容积( LVEDV)［( 124.98±20.53)mL、(118.43±16.13)mL］、左室收缩期末容积( LVESV)［( 58.12±5.84)mL、(43.15±5.67)mL］水平均升高，差异有统计学意义( P<0.05)；与透析前相比，透析后尿毒症血液透析病人血清血清转氨酶、 RET百分比、 Scr、BUN、β2-MG、LVEDV、LVESV水平下降( P<0.05)。尿毒症血液透析病人透析前、后 RET百分比、血清转氨酶水平与 Scr、BUN、β2-MG、LVEDV及 LVESV均呈正相关( P<0. 05)三年存活组病人透析前、透析后 RET百分比［(1.32±0.14)×109/L、(1.11±0.12)×109/L］、血清 AST［( 49.26±6.94)U/L、(39.24±6.83)U/L］及 ALT［( 53.94±7.09)U/L、(42.96±7.03)U/L］水平均明显低于死亡组［( 1.53±0.16)×109/L、(1.31±0.14)×109/L、(56.34±7.63)U/L、(45.37±6.24)U/L、(61.49±8.17)U/L、(48.38±6.26)U/L］，差异有统计学意义( P<0. 05)。结论 RET百分比、血清转氨酶在尿毒症血液透析病人透析前呈现高水平，透析后水平降低， RET、血清转氨酶水平的测定可能有助于判断尿毒症血液透析病人的预后。 |
| 英文摘要: |
| Objective To observe the levels of reticulocyte (RET) and serum aminotransferase in uremic hemodialysis patients, andto explore the relationships between them and the prognosis of uremic hemodialysis patients.Methods Seventy-eight cases of uremichemodialysis patients admitted to Sichuan Provincial People's Hospital from June 2015 to June 2016 were selected, and 78 healthy persons in the same period were selected as the control group. RET level was measured by automatic blood analyzer, serum transaminaselevel was measured by enzyme-linked immunosorbent assay (ELISA), renal function was measured by multi-functional automatic biochemical analyzer, cardiac function was measured by color Doppler echocardiography, RET in uremic patients with hematological analysis was analyzed, and the correlations between RET, serum transaminase and cardiac, renal functions in uremic patients with hematological were analyzed.Results ① The serum creatinine (Scr) [Before dialysis: (186.45±61.38) μmol/L vs. After dialysis: (138.76± 46.81) μmol/L vs. Control group: (101.48±33.41) μmol/L], blood urea nitrogen (BUN) [Before dialysis: (13.21±4.87) mmol/L vs. After dialysis: (9.63±3.18) mmol/L vs. Control group: (6.49±2.11) mmol/L], β2-microglobulin (β2-MG) [Before dialysis: (29.14±9.23) mg/L vs. After dialysis: (22.47±6.94) mg/L vs. Control group: (16.43±5.07) mg/L], left ventricular end diastolic volume (LVEDV) [Before dialysis: (124.98±20.53) mL vs. After dialysis: (118.43±16.13) mL vs. Control group: (112.23±20.31) mL] and left ventricular end systolic volume (LVESV) [Before dialysis: (58.12±5.84) mL vs. After dialysis: (43.15±5.67) mL vs. Control group: (37.28±5.43) mL] before and after dialysis in uremic hemodialysis patients were higher than those of the control group, and the difference was statistically significant(P<0.05); compared with before dialysis, the levels of serum aminotransferase, RET%, Scr, BUN, β2-MG, LVEDV, LVESV in uremic hemodialysis patients after dialysis decreased, with statistical significances (P<0.05). ② Before and after dialysis, RET% and serum aminotransferase levels in were positively correlated with Scr, BUN, β2-MG, LVEDV and LVESV, and the differences were statistically significant (P<0.05). ③ The levels of serum RET% [(1.32±0.14) ×109/L, (1.11±0.12) ×109/L], AST [(49.26±6.94) U/L, (39.24±6.83) U/ L] and ALT [(53.94±7.09) U/L, (42.96±7.03) U/L] before and after dialysis in the three-year survival group were significantly lower than those in the death group [(1.53±0.16) ×109/L, (1.31±0.14) ×109/L, (56.34±7.63) U/L, (45.37±6.24) U/L, (61.49±8.17) U/L, (48.38±6.26) U/L], and the differences were statistically significant (P<0.05).Conclusions RET and serum aminotransferase in uremic hemodialysis patients are high before dialysis, and the levels decrease after dialysis. The determination of RET and serum aminotransferase maybe helpful in judging the prognosis of hemodialysis patients with uremia. |
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