维持性血液透析患者炎性反应因子水平与左心室结构和功能的关系  

Relationship between inflammatory factors and left ventricular structure and function in maintenance hemodialysis patients

作　　者：李辉[1] 宋洁[1] 李瑛[1] 李静[2] 张晓东[1] 石理华[1] 

机构地区：[1]武警医学院附属医院肾病科,天津300162 [2]天津市东丽医院肾病科,300400

出　　处：《武警医学》2011年第2期110-112,共3页Medical Journal of the Chinese People's Armed Police Force

基　　金：天津市自然科学基金面上项目(09JCYBJC09900)

摘　　要：目的观察维持性血液透析(maintenace hemodialysis,MHD)患者体内高敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)浓度的变化,探讨MHD患者微炎性反应状态对左心室结构和功能的影响。方法选择MHD患者60例作为血液透析组,选取20例诊断为慢性肾功能不全尿毒症期,非透析患者作为非透析组,检测两组血IL-6、TNF-α、hs-CRP、尿素氮(BUN)、肌酐(SCr)水平;用二维彩色多普勒超声显像仪测定心脏LAD、LVDs、IVST、LVPWT、LVEF,并计算LVMI,分析hs-CRP与左心室结构和功能变化的关系。结果 (1)透析组患者血清hs-CRP、IL-6、TNF-α水平均高于非透析组,差异有统计学意义(P<0.05);(2)透析组LAD、LVDs、IVST、LVPWT、LVMI检测值均高于非透析组,LVEF低于非透析组,差异有统计学意义(P<0.05);(3)MHD患者血清hs-CRP与LAD、LVDs、IVST、LVPWT、LVMI呈正相关(P<0.05),与LVEF呈负相关(P<0.05)。结论MHD不能改善微炎性反应状态,治疗过程本身还会促进、加重微炎性反应;微炎性反应状态在MHD患者左心室结构和功能损害中发挥了重要作用。Objective To study the changes in serum levels of hs - CRP, IL - 6 and TNF -α in maintenance hemodialysis patients,to measure the indicators of structure and function of left ventricle by echocardiography, and to investigate the effects of micro- inflammatory reaction on left ventricular structure and function in maintenance hemodialysis patients. Method Sixty patients with uremia undergoing maintenance hemodialysis were selected as MHD group . And 20 non - dialysis patients with uremia were recruited as the control group. The serum hs- CRP,IL-6,TNF-α BUN and Cr were assayed in the MHD group and the control group. Two- dimensional color Doppler eehocardiography was used to measure LAD, LVDs, IVST, LVPWT, and LVEF , calculating LVMI, analyzing the relationship between the serum level of hs - CRP and the changes in left ventricular structure and function. Results （1） The serum levels of hs - CRP, IL - 6, and TNF - α in the MHD group were higher than those in the control group ; the difference was statistically significant （ P 〈 0.05）. （2）LAD, LVDs,IVST, LVPWT,and LVMI in the MHD group were higher than those in the control group, while the LVEF was lower than that in the control group （P 〈 0.01 ） ;the difference was statistically significant （ P 〈 0.05 ）. （3）The correlation analysis indicated that hs -CRP and LAD, LVDs,IVST, LVPWT, and LVMI in MHD patients were negatively interrelated（P 〈 0. 05） ,while hs- CRP and LVEF were positively interrelated （P 〈 0.05 ）. Conclusions Maintenance hemodialysis does not improve microinflammatory state,and treatment process itself also boosts and increases microinflammation.

关 键 词：炎性因子 左心室 维持性血液透析 微炎性反应 

分 类 号：R459.5[医药卫生—治疗学]