血液透析患者丙型肝炎病毒感染对动脉粥样硬化及左心室肥厚影响的研究  

The influence of hepatitis C virus infection on atherosclerosis and left ventricular hypertrophy in maintenance hemodialysis patients

作　　者：李海明[1] 陈靖[1] 殷莺[1] 匡鼎伟[1] 龙泉[1] 顾勇[1] 

机构地区：[1]复旦大学附属华山医院肾内科,上海200040

出　　处：《中国血液净化》2009年第11期597-600,共4页Chinese Journal of Blood Purification

摘　　要：目的探讨维持性血液透析(MHD)患者中丙型肝炎与炎症因子及动脉粥样硬化、左室肥厚的关系。方法40名维持性血液透析患者,其中丙型肝炎抗体阳性患者20名,抗体阴性患者20名。测定颈动脉内膜中层厚度(IMT)、心超及常规生化数据,并记录临床数据。结果丙型肝炎抗体阳性组IMT[(1.25±0.36)比(0.96±0.27)mm,P<0.05]、C反应蛋白(CRP)明显高于抗体阴性组[(5.56±2.34)比(2.25±1.34)mg/l,P<0.001]。丙型肝炎抗体阳性组患者胆固醇(CHO)、白蛋白(Alb)、前白蛋白(pre-Alb)、血红蛋白(Hb)、体重指数(BMI)均低于抗体阴性组患者。两组患者心超结果左室内径(LVD)、左房内径(LAD)、左室后壁厚度(LVPWT)、室间隔厚度(IVST)、左室射血分数(LVEF)、左室质量指数(LVMI)没有明显的差异。结论MHD患者丙型肝炎病毒感染与动脉粥样硬化有关;可能由于尿毒症其他因素的影响,丙型肝炎病毒感染对心肌病变的影响没有在这组患者中反映出来。Objective To observe the correlation of hepatitis C virus （HCV） infection with inflamma- tion-related factors, atherosclerosis and left ventricular hypertrophy in maintenance hemodialysis （MHD） patients. Methods In a cohort of 40 MHD patients, anti-HCV antibody was found in 20 patients, and negative anti-HCV antibody was found in the remaining 20 patients. Serum albumin, hemoglobin, blood lipids and C-reactive protein were examined by routine methods. The intima thickness （IMT） of carotid artery was measured by high resolution B-mode ultrasonography. Left ventricular diameter （LVD）, left atrial diameter （LAD）, left ventricular mass index （LVMI）, left ventricular posterior wall thickness （LVPWT）, interventricular septal thickness （IVST）, and left ventricular ejection fraction （LVEF） were measured by ultrasonic cardiography. Results IMT （1.25±0.36）mm vs. （0.96 ± 0.27）mm, P 〈 0.05） and CRP （5.56 ± 2.34）mg/L vs. （2.25 ±1.34）mg/L, P 〈 0.001） were significantly higher in anti-HCV antibody positive patients than in negative patients, while cholesterol, albumin, pre-albumin, hemoglobin and body weight index were lower in anti-HCV antibody positive patients than in negative patients. No differences were found in LVD, LAD, LVPWT, IVST, LVEF and LVMI between anti-HCV antibody positive and negative patients. Conclusion In MHD patients, HCV infection is correlated with atherosclerosis. Since MHD patients are usually complicated with several uremia-related risk factors for cardiovascular diseases, the effect of HCV infection on left ventricular hypertrophy may be underestimated in this study.

关 键 词：血液透析 丙型肝炎病毒 动脉粥样硬化 左室肥厚 

分 类 号：R318.16[医药卫生—生物医学工程] R512.6[医药卫生—基础医学]