CRP、PTH、Alb及Hb水平变化与尿毒症周围神经病变程度的相关性

摘要 目的：探讨C反应蛋白（CRP）、甲状旁腺素（PTH）、血清白蛋白（Alb）及血红蛋白（Hb）水平变化与尿毒症周围神经病变程度的相关性。方法：选取我院2019年4月到2022年4月收治的340例需要进行维持性血液透析治疗的尿毒症患者作为研究对象，依照是否存在周围型神经病变的情况分为非神经病变组（n=132）和神经病变组（n=208）。对比两组患者的临床相关资料，CRP、PTH、Alb及Hb水平变化，其他血清指标变化，并分析CRP、PTH、Alb及Hb水平变化与尿毒症周围神经病变程度的相关性。结果：两组患者高血压患病人数对比无差异（P＞0.05），两组患者的糖尿病患病人数、血液透析频率以及血液透析时间对比差异显著（P<0.05）；神经病变组患者的CRP、PTH水平明显高于非神经病编组（P＜0.05），神经病变组患者的Alb、Hb水平明显低于非神经病变组（P＜0.05）；两组患者血浆胆固醇（CHO）、红细胞（RBC）、三酰甘油（TG）、血肌酐（SCr）水平对比无显著差异（P＞0.05），神经病变组患者血清前白蛋白（PA）、二氧化碳结合力（CO2CP）水平低于非神经病变组，神经病变组患者血清BUN、FBG水平高于非神经病变组（P＜0.05）；Spearman相关分析结果显示：CRP、PTH与尿毒症周围神经病变程度呈正相关（P＜0.05），Alb、Hb与尿毒症周围神经病变程度呈负相关（P＜0.05）。结论：CRP、PTH、Alb及Hb水平变化与尿毒症周围神经病变程度具有明显关系，可以用于判断尿毒症患者的周围神经病变程度。而且尿毒症周围神经病变患者多数原发疾病为糖尿病，血液透析频率较低，维持血液透析时间较长。

Correlation between The Changes of CRP, PTH, ALB and Hb Levels and The Severity of Uremic Peripheral Neuropathy

ABSTRACT Objective: To investigate the correlation between the changes of C-reactive protein (CRP), parathyroid hormone (PTH), serum albumin (ALB) and hemoglobin (HB) and the degree of uremic peripheral neuropathy. Methods: From April 2019 to April 2022, 340 patients with uremia who need maintenance hemodialysis in our hospital were selected as the research objects, and they were divided into neuropathy group (n=132) and non neuropathy group (n=208) according to whether there was peripheral neuropathy. The clinical data, the changes of CRP, PTH, ALB and Hb levels and other serum indexes of the two groups were compared, and the correlation between the changes of CRP, PTH, ALB and Hb levels and the degree of uremic peripheral neuropathy was analyzed. Results: There was no difference in the number of patients with hypertension between the two groups (P>0.05), but there were differences in the number of patients with diabetes, hemodialysis frequency and hemodialysis time between the two groups (P<0.05); the levels of CRP and PTH in the neuropathy group were higher than those in the non neuropathy group(P<0.05), and the levels of ALB and Hb in the neuropathy group were lower than those in the non neuropathy group. There was no significant difference in plasma cholesterol(CHO), red blood cells (RBC), triacylglycerol (TG), and blood creatinine (SCr) levels between the two groups (P>0.05). The serum prealbumin (PA) and carbon dioxide binding force (CO2CP) levels in the neuropathy group were lower than those in the non-neuropathy group, and the serum BUN and FBG levels were higher than those in the non-neuropathy group(P<0.05). The results of correlation analysis showed that CRP and PTH were positively correlated with the degree of uremic peripheral neuropathy (P<0.05), while ALB and Hb were negatively correlated with the degree of uremic peripheral neuropathy(P<0.05). Conclusion: The levels of CRP, PTH, ALB and Hb are significantly related to the degree of uremic peripheral neuropathy, which can be used to judge the degree of uremic peripheral neuropathy. Moreover, most of the primary diseases of uremic peripheral neuropathy patients are diabetes, the frequency of hemodialysis is low, and the maintenance of hemodialysis time is long.