- 期刊
腹膜透析病人的潛在性發炎狀況與腹膜炎發生之相關性
Association of Sub-Clinical Inflammation Status and Peritonitis Development in Peritoneal Dialysis Patients
摘要
尿毒症病人處於慢性發炎，潛在原因包括體內的尿毒環境、氧化壓力、蛋白質熱量耗損 (protein-energy wasting, PEW)、及感染，慢性發炎與尿毒症病人發生心血管疾病及死亡密切相關。發炎時常會伴隨急性期反應，C 反應蛋白 (C reactive protein, CRP) 會上升，白蛋白 (albumin) 則會下降。潛在發炎狀態對於腹膜透析病人也會有不良的影響。CRP 與白蛋白的濃度呈現負相關，臨床狀況穩定的病人，CRP 與albumin 的比值 (CRP/albumin ratio) 仍會不斷波動。將CRP 及albumin 合併來看，能更正確的評估尿毒症病人慢性發炎的嚴重程度及預後。
並列摘要
Chronic and recurrent inflammation is common in patients with end-stage renal disease (ESRD). Many factors including the uremic milieu, elevated levels of circulating pro-inflammatory cytokines, oxidative stress, carbonyl stress, protein-energy wasting (PEW), and infections are probable underlying causes of chronic inflammation. Measurement of the levels of acute-phase proteins, such as C-reactive protein (CRP) and albumin, is frequently utilized to define the presence and/or degree of inflammation in patients with ESRD. Chronic inflammation may be related to accelerated atherosclerosis, protein-energy malnutrition, and anemia. Increased levels of markers of inflammation and malnutrition predict a poor outcome in patients with ESRD. Increased serum CRP levels in ESRD patients is a strong predictor of cardiovascular mortality. Higher levels of high-sensitivity CRP (hs-CRP) predicts mortality and technique failure in peritoneal dialysis patients. Besides, a progressive increase in the hs-CRP level had been demonstrated to be associated with elevated risk of peritonitis in PD patients. Level of CRP is negatively associated with albumin. Clinically stable dialysis patients with fluctuated CRP-to-Albumin ratio tend to have longer subsequent hospitalization stay and higher mortality risk. Periodic measurement of CRP and albumin to assess severity and frequency of inflammation is reasonable in patients with ESRD.
被引用紀錄
延伸閱讀
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