中文摘要：

目的探讨慢性肾病（CKD）高龄男性患者血清C-反应蛋白（CRP）与营养指标及CKD进展之间的关系。方法回顾性分析曾在某院住院并门诊随访且尚未透析的72例高龄男性CKD 5期患者,分为高GRP组28例,低GRP组44例,观察血清CRP、营养评估及肾功能指标等,探讨微炎性状态与营养状况及CKD进展之间的关系。结果排除感染、创伤等因素后,所纳入对象的平均血清CRP水平为0.64mg/dl（四分位间距0.32,1.05 mg/dl）。以0.8mg/dl为分割点,将其分为高CRP组（CRP≥0.8mg/dl）和低CRP组（CRP〈0.8mg/dl）。高CRP组患者占38.9%,较之低CRP组,高CRP组多伴随心血管及外周动脉粥样硬化等疾病（P〈0.05）,主观综合营养评估（SGA）评分明显降低（P〈0.01）,促红细胞生成素（EPO）用量显著增加（P〈0.01）。随访18个月后,高CRP组估算肾小球滤过率下降幅度明显（P〈0.01）,转入透析治疗的例数较多（P〈0.05）,发生心血管事件的例数也显著增多（P〈0.05）。结论进入CKD 5期的高龄CKD患者存在血清CRP值轻度升高的微炎性状态,高CRP患者伴随心血管病及外周动脉粥样硬化的比例显著高于低CRP患者;持续的高CRP水平多伴随营养状况的下降,且易导致EPO效力的降低;CKD的进展与血清高CRP水平具有相关性。

英文摘要：

Objective To investigate the relationship of CRP to nutritional condition and the renal function in the very elderly with end stage renal disease（ESRD）.Methods This was a retrospective cohort study using the clinical data of 89 very old patients（aged75～97） with ESRD.According to the level of serum CRP,the patients were divided into two groups：high CRP group（CRP≥ 0.8mg/dl） and low CRP group（0.8mg/dl）.The changes of nutritional parameters and the renal function were compared between two groups at baseline and 18 months of follow-up.Results Twenty-eight patients（38.9%） showed high CRP levels（≥0.8mg/dl）at baseline.After 18 months of follow-up,the patients with high CRP showed lower level of SGA score,furthermore they needed more ery thropoietin to maintain stable hemoglobin（P0.05）.The high CRP group had a faster decline in eGFR over the 18 months of follow-up duration（P0.05）.Conclusions High CRP levels in the very elderly with ESRD could predict the nutritional decline and poorer response to EPO.There are relationship between serum CRP and the progression of CKD.