慢性肾衰竭患者血浆中可溶性血管细胞黏附分子1的变化及意义  

The change of plasma soluble vascular cell adhension molecule-1 in chronic renal failure patients and its significance

作　　者：姜立萍[1] 黄雯[1] 翟艳苓[1] 刘宁[1] 

机构地区：[1]首都医科大学附属北京同仁医院肾内科,北京100730

出　　处：《中国血液净化》2011年第1期37-40,共4页Chinese Journal of Blood Purification

摘　　要：目的观察慢性肾衰竭(chronic renal failure,CRF)患者血浆中可溶性血管细胞黏附分子1(soluble vascular cell adhesion molecule-l,sVCAM-1)的变化以及与C反应蛋白(C-reactive protein,CRP)和可溶性CD40配体(soluble CD40 ligand,sCD40L)之间的关系,探讨其在肾损伤和免疫异常中的可能作用。方法选择首都医科大学附属北京同仁医院肾内科收治的CRF未透析患者(CRF组)30例,血液透析(hemodialysis,HD)中心维持性血液透析(maintenance hemodialysis,MHD)3个月以上的尿毒症患者(HD组)30例,与患者年龄、性别相匹配的健康正常对照组20例。采用酶联免疫吸附法(ELISA)测定血浆sVCAM-1的水平,并进行相关因素分析,观察HD对sVCAM-1的影响。用方差分析和Pearson相关性分析进行统计学处理。结果 CRF组和HD组sVCAM-1、CRP和sCD40L水平均明显高于对照组(P<0.01),HD组sVCAM-1和sCD40L水平较CRF组升高(P<0.05);CRF组sVCAM-1水平与CRP和sCD40L之间成正相关(P<0.05),与血清肌酐(serum creatinine,SCr)之间成正相关(P<0.01),HD组sVCAM-1水平与CRP之间成正相关(P<0.01),与sCD40L和SCr之间无相关性(P>0.05);一次HD过程,HD后sVCAM-1水平较HD前明显升高(P<0.01)。结论 CRF患者血浆中sVCAM-1水平升高,HD患者更明显,可能与微炎症状态有关,可能参与CRF患者的肾损伤和免疫异常。Objective To observe the change of plasma soluble vascular cell adhension molecule-1（sVCAM-1） and its relationship to C-reactive protein（CRP） and soluble CD40 ligand（sCD40L） in chronic renal failure（CRF） patients,and to explore their potential effects on renal injury and immunodeficiency.Methods We recruited 30 CRF patients without hemodialysis（CRF group） treated in the Department of Nephrology,Beijing TongRen Hospital of Capital Medical University,30 uremic patients on maintenance hemodialysis for more than 3 months（HD group） treated in the Dialysis Center of this hospital,and 20 healthy volunteers（normal control group） matched with the patients in age and gender.Plasma sVCAM-1 was measured by enzyme linked immunosorbent assay method.The relationship between sVCAM-1 and related factors,and the influence of hemodialysis on plasma sVCAM-1 were analyzed.ANOVA and Pearson correlation analysis were used for statistical analysis.Results Plasma sVCAM-1,CRP and sCD40L were significantly higher in CRF group and HD group than in the control group（P0.01）.Plasma sVCAM-1 and sCD40L were higher in HD group than in CRF group（P0.05）.In CRF group,sVCAM-1 level was positively correlated with CRP and sCD40L（P0.05）,and with serum creatinine（Scr）（P0.01）.In HD group,sVCAM-1 level was positively correlated with CRP（P0.01）,but had no correlations with Scr and sCD40L（P0.05）.After one HD session,plasma sVCAM-1 increased significantly,compared to that before the HD（P 0.01）.Conclusion Elevation of plasma sVCAM-1 occurs in CRF patients especially in those on hemodialysis,which may relate to the microinflammatory state and may also be involved in the renal injury and abnormal immune function in these patients.

关 键 词：可溶性血管细胞黏附分子1 慢性肾衰竭 血液透析 炎症因子 

分 类 号：R629.5[医药卫生—整形外科]