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血小板体积降低是否可预测慢性肾衰竭、透析和移植患者的炎症?

Does decreased mean platelet volume predict inflammation in chronic renal failure, dialysis, and transplanted patients?

机构信息

Department of Hematology .

出版信息

Ren Fail. 2014 Feb;36(1):69-72. doi: 10.3109/0886022X.2013.832310. Epub 2013 Sep 13.

Abstract

OBJECTIVES

Increased platelet activation contributes to cardiovascular mortality in chronic kidney disease patients (CKD). Larger platelets are more active and this increased activity had been suggested as a predictive biomarker for cardiovascular disease. In this study, we aimed to evaluate mean platelet volume (MPV) as an inflammatory marker in a broadened group of CKD patients. Our study is unique in literature as it covers all types of CKD including renal replacement therapies.

MATERIALS AND METHODS

200 patients (50 renal transplanted, 50 hemodialysis, 50 peritoneal dialysis, 50 chronic renal failure stages 3-4) were investigated who were between 18 and 76 years of age. The collected data included demographic properties, platelet count, MPV, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and hemoglobin. All of the patients had at least 12 month of therapy of either renal replacement modality.

RESULTS

The mean CRP value was detected statistically significantly higher in hemodialysis (HD) patients compared to the resting three groups of patients (p < 0.01). Mean CRP level was detected significantly higher in the pre-dialysis group compared to transplanted and peritoneal dialysis (PD) patients (p < 0.01). There is no statistically significant difference detected among the mean MPV values of all patient groups (p > 0.05).

CONCLUSIONS

ESR and CRP were significantly increased in hemodialysis patients compared to the other groups. We did not detect a significant difference among MPV between the groups. ESR was detected lowest in transplanted patients. Transplantation is coming forward as the favorable choice of renal replacement therapy which decreases inflammation.

摘要

目的

血小板活化增加与慢性肾脏病(CKD)患者的心血管死亡率有关。较大的血小板更活跃,这种活性增加被认为是心血管疾病的预测生物标志物。在这项研究中,我们旨在评估平均血小板体积(MPV)作为更广泛的 CKD 患者的炎症标志物。我们的研究在文献中是独特的,因为它涵盖了包括肾脏替代治疗在内的所有类型的 CKD。

材料和方法

研究共纳入 200 例患者(50 例肾移植、50 例血液透析、50 例腹膜透析、50 例慢性肾衰竭 3-4 期),年龄在 18 至 76 岁之间。收集的数据包括人口统计学特征、血小板计数、MPV、C 反应蛋白(CRP)、红细胞沉降率(ESR)和血红蛋白。所有患者均接受了至少 12 个月的肾脏替代治疗。

结果

与其他三组患者相比,血液透析(HD)患者的平均 CRP 值显著升高(p<0.01)。与移植和腹膜透析(PD)患者相比,透析前组的平均 CRP 水平显著升高(p<0.01)。所有患者组的平均 MPV 值之间没有统计学上的显著差异(p>0.05)。

结论

与其他组相比,血液透析患者的 ESR 和 CRP 显著升高。我们没有发现组间 MPV 有显著差异。ESR 在移植患者中最低。移植作为一种降低炎症的肾脏替代治疗的有利选择,正在得到越来越多的关注。

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