目的 通过观察终末期肾脏病(end-stage renal disease,ESRD)患者血液透析前、后脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,LpPLA2)的活性变化及血清C反应蛋白(C-reactive protein,CRP)的浓度水平，探讨血液透析对ESRD患者此炎症指标表达的影响。 方法 收集20例ESRD进行血液透析患者透析前、透析中2 h及透析完毕后外周血8 ml，年龄、性别相匹配的健康体检者20例作为正常对照组。利用免疫比浊法检测血清中CRP的浓度水平；酶联免疫吸附法测定LpPLA2的活性变化。 结果 在透析前，ESRD患者血清CRP的浓度水平均较正常对照组高(P＜0.01)；而LpPLA2的活性在ESRD患者和正常对照组之间差异无统计学意义(P＞0.05)。透析完毕后，血清CRP浓度水平与透析前、透析中差异均无统计学意义(均P＞0.05)；而LpPLA2的活性在透析中及透析完毕后均较透析前明显提高(P＜0.01)。 结论 血液透析对ESRD患者会产生微炎症状态，此炎症反应状态或许部分是通过提高LpPLA2的活性来介导的。

Objective To explore the influence of hemodialysis (HD) on the expression of inflammation marker lipoprotein-associated phospholipase A2 (LpPLA2) in end stage renal disease (ESRD) patients, we evaluated their changes in LpPLA2 activity and C-reactive protein (CRP) concentration before and after HD. Methods We observed 20 ESRD patients on HD, from whom 8ml peripheral blood were taken just before HD, after 2 h during HD, and immediately after HD. C-reactive protein was estimated by turbidometric assay, and LpPLA2 activity was measured by enzyme-linked immunosorbent assay (ELSA). Result In ESRD patients before HD, CRP concentration was higher than normal controls (P＜0.01), but LpPLA2 activity was indifferent from the controls (P＞0.05). In ESRD patients after a HD session, CRP concentration did not change significantly (P＞0.05), as compared to that before HD and after 2h during HD. However, LpPLA2 activity increased greatly after 2h during HD and after a HD session (P＜0.01), as compared to that before HD. Conclusion Hemodialysis can induce microinflammation in ESRD patients. This pro-inflammatory state may be introduced partially by the increase of LpPLA2 activity.