维持性血液透析患者血清脂联素水平与慢性炎症 动脉粥样硬化关系的研究  

The relationship between serum adiponectin level and chronic inflammation,atherosclerosis in maintenance hemodialysis patients.

作　　者：李忠心[1] 孟娟[1] 彭立人[1] 

机构地区：[1]首都医科大学附属北京朝阳医院肾内科,北京100020

出　　处：《中国实用内科杂志》2008年第10期863-865,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的探讨维持性血液透析(MHD)患者血清脂联素(ADPN)质量浓度与慢性炎症、动脉粥样硬化的关系。方法选择2005年10月至2006年1月首都医科大学附属北京朝阳医院肾内科MHD患者60例和对照者30例,分别测定血清ADPN和C-反应蛋白(CRP)、白细胞介素-6(IL-6),应用彩色多普勒超声检测颈动脉内膜-中层厚度(IMT)及肱动脉舒张功能的变化。结果MHD患者血清ADPN(0.99±0.37)明显高于对照组(0.39±0.14)。血清ADPN与CRP、IL-6呈负相关(r分别为-0.22、-0.31、P<0.05)。MHD患者IMT非增厚者血清ADPN(1.24±0.31)明显高于增厚者血清ADPN(0.74±0.29)。血清ADPN与颈动脉IMT呈负相关(r为-0.26,P<0.05)。MHD患者反应性充血后肱动脉内径变化率明显低于对照组,血清ADPN与反应性充血后肱动脉内径变化率呈正相关(r为0.27,P<0.05),多元逐步回归分析表明血清ADPN是颈动脉IMT及反应性充血后肱动脉内径变化率的影响因素。结论维持性血液透析患者血清ADPN升高,高质量浓度的ADPN可以减少维持性血液透析患者慢性炎症、动脉粥样硬化的发生。Objective To determine the relationship between serum adiponectin level and chronic inflammation, atherosclerosis in maintenance hemodialysis （MHD） patients. Methods Totally 60 MHD patients and 30 healthy volunteers were included in this study. Serum adiponeetin level （ ADPN ） and C-reative protein （ CRP ）, interleukin-6 （ IL-6 ） were measured. Carotid initial-medial thickness（IMT） and braehial arterial vasodilation were determined by echocardiography. Results Serum ADPN level（0. 99 ± 0. 37 ）was higher in MHD patients than that （0. 39 ± 0. 14 ） in controls. The ADPN level of higher IMT group was lower than that in normal IMT group. CRP,IL-6 and Cartid IMT were negatively correlated with ADPN（ r = -0. 22, -0. 31 -0. 26 ,P 〈 0. 05 ）. The change in brachial artery diameter during reactive hyperemia in MHD patients was lower than that in controls. The change in braehial artery diameter during reactive hyperemia was positively correlated with ADPN （ r = 0. 27, P 〈 0. 05 ）. Multivariate stepwise regression indicated that the correlation also existed independently of other conventional risk factors. Conclusion Serum adiponectin level is higher in MHD patients. ADPN may be a protective agent for the blood vessel. The high level of ADPN can decrease chronic inflammation and atherosclerosis in maintenance hemodialysis patients.

关 键 词：维持性血液透析 动脉粥样硬化 脂联素 

分 类 号：R5[医药卫生—内科学]