Brouillard M, Reade R, Boulanger E, Cardon G, Dracon M, Dequiedt P, Pagniez D
Clinique Néphrologique, Centre Hospitalier Universitaire, Lille, France.
Nephrol Dial Transplant. 1996 Nov;11(11):2244-7. doi: 10.1093/oxfordjournals.ndt.a027143.
Erythrocyte sedimentation rate is widely used in the general population. It has seldom been studied in patients with chronic renal failure. The purpose of this study was to assess its usefulness in haemodialysis patients.
Forty-five haemodialysis patients with no evidence of acute or chronic inflammatory illness were studied. Nine were diabetic, and 12 used a non-biocompatible membrane. Erythrocyte sedimentation rate was determined, using a modified Westergren method. Plasma fibrinogen concentration, complete blood count, and serum chemistries were also studied.
Erythrocyte sedimentation rate was normal or mildly elevated in most of our patients, with a median of 30 mm/h. Linear analysis found positive correlation between erythrocyte sedimentation rate and fibrinogen concentration, globulin level, platelet, and white cell counts, and negative correlation with haematocrit. Fibrinogen concentration was normal in 22 patients, and moderately elevated in 14. It was significantly higher in diabetic patients, or those using a non-biocompatible membrane. The same positive correlations were found for fibrinogen concentration as for erythrocyte sedimentation rate.
We conclude that erythrocyte sedimentation rate can be used in haemodialysis patients much in the same way as in the general population, as it is influenced by the same factors, and its baseline value is lower than previously reported. The lower concentration of fibrinogen, an independent predictor of cardiovascular risk, in patients treated with biocompatible membranes may be of clinical relevance.
红细胞沉降率在普通人群中广泛应用。在慢性肾衰竭患者中对其研究较少。本研究的目的是评估其在血液透析患者中的实用性。
对45例无急性或慢性炎症性疾病证据的血液透析患者进行研究。9例为糖尿病患者，12例使用非生物相容性膜。采用改良魏氏法测定红细胞沉降率。还研究了血浆纤维蛋白原浓度、全血细胞计数和血清化学指标。
大多数患者的红细胞沉降率正常或轻度升高，中位数为30mm/h。线性分析发现红细胞沉降率与纤维蛋白原浓度、球蛋白水平、血小板和白细胞计数呈正相关，与血细胞比容呈负相关。22例患者的纤维蛋白原浓度正常，14例中度升高。糖尿病患者或使用非生物相容性膜的患者纤维蛋白原浓度显著更高。纤维蛋白原浓度与红细胞沉降率呈现相同的正相关关系。
我们得出结论，红细胞沉降率在血液透析患者中的应用方式与普通人群大致相同，因为它受相同因素影响，且其基线值低于先前报道。生物相容性膜治疗的患者中纤维蛋白原浓度较低，而纤维蛋白原是心血管风险的独立预测因子，这可能具有临床意义。
