检验医学 ›› 2012, Vol. 27 ›› Issue (3): 171-173.

• 生物化学检验论著 • 上一篇    下一篇

C反应蛋白与血清铁参数联合检测在rHuEPO治疗肾性贫血中临床价值探讨

李香玲,王炎强,赵学兰,郭振涛,李加村,肖青   

  1. 潍坊医学院附属医院肾内科,山东 潍坊 261031
  • 收稿日期:2012-01-10 出版日期:2012-03-30 发布日期:2012-03-16
  • 作者简介:李香玲,女,1974年生,硕士,主治医师,主要研究方向为慢性肾脏病贫血病理生理、机制研究。
  • 基金资助:

    潍坊市科技局资助项目(200902080)

Investigation on the clinical significance of combining determination of C reactive protein and serum iron parameters for the rHuEPO treatment of renal anemia

  • Received:2012-01-10 Online:2012-03-30 Published:2012-03-16

摘要: 目的 探讨C反应蛋白(CRP)与血清铁参数检测在重组人促红细胞生成素(rHuEPO)治疗肾性贫血(RA)中的临床应用价值。方法 将75例RA患者按CRP水平分为Ⅰ组 (CRP>8 mg/L)37例、Ⅱ组(CRP≤8 mg/L)38例。所有RA患者均应用rHuEPO治疗[80~120 U/(kg·周),分2次注射]。治疗前检测红系[红细胞(RBC)、血红蛋白(Hb)、红细胞压积(HCT)、网织红细胞计数百分比(RET%)]及铁代谢参数[血清转铁蛋白受体(sTfR)、血清铁(SI)、转铁蛋白饱和度(TS%)、血清铁蛋白(SF)]、CRP等指标,治疗后第2、4、8周测定红系指标,第8周检测铁代谢参数,并进行统计学分析。结果 2组患者治疗前sTfR水平差异有统计学意义(P<0.05)。治疗后Ⅱ组红系指标及sTfR均升高,SF下降,与治疗前及Ⅰ组治疗后比较差异有统计学意义(P<0.05)。Ⅰ组CRP与Hb呈负相关(r=-0.55,P<0.01)、与SF呈正相关(r=0.65,P<0.01)。Ⅱ组sTfR与Hb呈正相关(r=0.71,P<0.01)、与SF呈负相关(r=-0.48,P<0.05)。结论 血清铁参数与CRP等指标联合检测可指导rHuEPO的应用,对评价及预测其疗效有重要的临床意义。

关键词: C反应蛋白, 血清铁参数, 重组人促红细胞生成素, 肾性贫血

Abstract: Objective To investigate the clinical application significance of combining determination of C reactive protein (CRP) and serum iron parameters for the recombinant human erythropoietin (rHuEPO) treatment of renal anemia(RA). Methods All 75 patients with RA were classified intoⅠ(CRP>8 mg/L, 37 patients) and Ⅱ(CRP≤8 mg/L, 38 patients) groups, and administrated rHuEPO at dose of 80120 U/kg for a week(2 times). Before the treatment, red cell indices[red blood cell (RBC), hemoglobin (Hb), hematocrit (HCT) and reticulocyte counting percentage (RET%)], iron metabolism parameters[serum transferrin receptor(sTfR), serum iron (SI), transferrin saturation (TS%) and serum ferritin (SF)] and CRP were measured. The iron metabolism parameters after the treatment 8 weeks and red cell indices after 2,4 and 8 weeks were measured, and the results were analyzed statistically. Results The 2 groups′ sTfR and CRP before the treatment were different statistically(P<0.05). After the treatment, red cell indices and sTfR in groupⅡ increased, and SF decreased. Compared with before treatment group and after treatment groupⅠ, there were significant differences (P<0.05). There was negative correlation between CRP and Hb(r=-0.55,P<0.01), and positive correlation between CRP and SF(r=0.65,P<0.01) in groupⅠ. In groupⅡ, sTfR and Hb were positively correlated (r=0.71,P<0.01), and sTfR and SF were negatively correlated (r=-0.48,P<0.05). Conclusions CRP combined with serum iron parameters can guide the application of rHuEPO, and has clinical significance in evaluating and predicting the effect of rHuEPO in the treatment of renal anemia.

Key words: C reactive protein, Serum iron parameter, Recombinant human erythropoietin, Renal anemia