终末期肾病微炎症状态和动脉粥样硬化的关系  

Relationship between microinflammation state of end stage renal disease and atherosclerosis

作　　者：叶云洁[1] 倪兆慧[1] 钱家麒[1] 何颖欣[1] 

机构地区：[1]上海第二医科大学附属仁济医院肾内科,200001

出　　处：《中华肾脏病杂志》2004年第3期173-176,共4页Chinese Journal of Nephrology

摘　　要：目的研究终末期肾病(ESRD)的微炎症状态与动脉粥样硬化的关系。方法以246例ESRD患者和肾功能正常的对照组43例为对象,监测其有关炎症因子和颈动脉B超指标,分析尿毒症微炎症状态及其与动脉粥样硬化的关系。结果ESRD患者血清中炎症性指标C反应蛋白(CRP)、白介素(IL)-6和肿瘤坏死因子(TNF)-α等的平均水平虽在正常范围内,但明显高于对照组。根据CRP水平分组后发现,CRP>4mg/L组在颈动脉B超各项指标和心脑血管事件发生率等方面与CRP<4mg/L组相比,差异有显著性意义。根据有无动脉粥样硬化心脑血管病史而分组后发现,阳性组患者血清中CRP、IL-6和TNF-α水平虽在正常范围内,但仍显著高于阴性组患者。结论尿毒症患者体内存在微炎症状态,这种微炎症状态可能是引起尿毒症高发动脉粥样硬化性心脑血管事件的独立危险因素之一。Objective To study the presence of microflammation state in ESRD patients and the relationship between microinflammation state and atherosclerosis. Methods Inflammatory cytokines and carotid artery B ultrasound data of 246 ESRD patients and 43 cases with normal renal function as control were collected. The presence of microflammation state and its relationship to atherosclerosis were studied. Results The levels of inflammatory cytokines(CRP,IL 6,TNF α)in ESRD patients were mostly in normal range, but still much higher than those in control.According to the level of CRP,the patients were divided into three groups.Significant differences of carotid artery B ultrasound and prevalence of cerebrocardiovasculer events were found between two groups with CRP levels less and higher than 4 mg/L. According to the history of atherosclerosis cerebrocardiovasculer disease,patients were divided into two groups. Levels of CRP, IL 6, TNF αwere higher in patients with cerebrocardiovasculer disease than those in patients without, but still in normal range. Conclusions There is a microinflammation status in ESRD patients. The microinflammation status may be a risk factor of high prevalence and mortality of atherosclerosis related cardiovascular events in ESRD patients.

关 键 词：终末期 肾病 微炎症状态 ESRD 动脉粥样硬化 尿毒症 

分 类 号：R692.5[医药卫生—泌尿科学]