老年血液透析者颈动脉粥样硬化与C-反应蛋白的关系  

Association between carotid atherosclerosis and serum C-reactive protein in elderly patients undergoing hemodialysis

作　　者：曹礼应[1] 余月明[1] 王柏青[1] 郭虹[1] 段建[1] 余开慧[1] 卓红爱[1] 

机构地区：[1]成都军区昆明总医院肾内科,云南省昆明市650032

出　　处：《实用老年医学》2006年第3期177-178,共2页Practical Geriatrics

摘　　要：目的探讨老年维持性血液透析（HD）患者颈动脉粥样硬化（AS）与C-反应蛋白（CRP）的关系. 方法测定33例老年及同期42例非老年HD患者临床指标、CRP及肱三头肌皮褶厚度（TSF）、上臂围（AC）、上臂肌围（AMC）;应用彩色B超测颈动脉内膜-中层厚度（IMT）及粥样硬化斑块情况. 结果老年HD患者AC、AMC、尿素氮（BUN）、血肌酐（Scr）、白蛋白（Alb）均显著低于非老年患者（P＜0.05～0.01）;而CRP水平、颈动脉平均IMT、斑块阳性率、增厚阳性率显著升高（P＜0.05～0.01）;HD患者颈动脉平均IMT与CRP、三酰甘油 （TG）、低密度脂蛋白（LDL）、年龄呈正相关,与Alb呈负相关（r=-0.053,P＜0.05）. 结论老年血液透析患者营养状况差,AS重,改善患者营养状况及微炎症、血脂异常可能减轻患者AS.Objective To investigate whether carotid atherosclerosis（AS） is associated with serum C-reactive protein （CRP）. Methods The clinical index, CRP and triceps skinfolds（TSF）, arm circumference（AC）, arm muscle circumference（AMC） were measured in 33 elderly and 42 young patients undergoing maintenance hemodialysis （HD）. The initma-media thickness（IMT） of extracranial common carotid artery and presence of atherosclerotic plaques were determined by B-mode uhrasonography. Results The AC,AMC, blood urea nitrogen（ BUN）, serum creatinine （Scr）, serum albumin （Alb） in elderly patients undergoing HD was lower than those in young patients;but serum CRP, mean IMT, prevalence of atherosclerotic plaque and increased IMT in carotid artery were high;The mean IMT of carotid artery correlated positively with CRP, triglycerides（TG） ,low density lipoprotein（LDL） ,age,but negatively with Alb in HI） patients. Conclusions The malnutrition and AS are serious in elderly HD patients. To improve nutrition, micro-inflammation and abnormal serum lipid might have better effect on treating AS in elderly HD patients.

关 键 词：肾透析 动脉硬化 C-反应蛋白质 老年人 

分 类 号：R459.5[医药卫生—治疗学] R534.4[医药卫生—临床医学]