维持性血液透析患者微炎症状态与颈动脉内中膜厚度进展的相关性研究  

Correlation between the micro-inflammatory state of maintenance hemodialysis patients and progression of carotid intima-media thickness

作　　者：张晓东[1] 张建荣[2] 朱愿[1] 宋洁[1] 李瑛[1] 李辉[1] 

机构地区：[1]武警后勤学院附属医院肾脏病科,天津300162 [2]武警总医院肾脏病科,北京100039

出　　处：《武警医学》2012年第12期1056-1059,共4页Medical Journal of the Chinese People's Armed Police Force

基　　金：天津市自然科学基金(09JCYBJC09900)

摘　　要：目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者微炎症状态与颈动脉内中膜厚度进展(pro-gression of carotid intima-media thickness,PROG-IMT)的相关性。方法 ELISA法测定对武警后勤学院血液净化中心93例符合标准的MHD患者高敏C反应蛋白水平(hs-CRP),据结果分为正常组(30例,hs-CRP水平<3 mg/L)与微炎症组(63例,hs-CRP水平3～15 mg/L),于2008-06至2011-05进行随访观察,采用彩色多普勒测定颈动脉内中膜厚度(IMT)(实验前后2次),观察PROG-IMT,监测血浆白蛋白、血红蛋白、血脂、尿素氮、肌酐、钙、磷、甲状旁腺素、透析充分性、血压等,并进行统计学相关分析。结果 (1)微炎症组:IMT有进展者56例;实验前、后2次IMT有差异,且差异有统计学意义(P<0.05);实验前后2次IMT为高度正相关(P<0.05);因心脑血管疾病死亡5例。正常组:IMT有进展者8例;实验前、后2次IMT差异无统计学意义(P>0.05);因心脑血管疾病死亡1例。(2)PROG-IMT与hs-CRP、年龄、血压、低密度脂蛋白正相关(P<0.05)。(3)多元逐步回归分析显示,hs-CRP是影响PROG-IMT的主要因素(P<0.05)。结论微炎症状态MHD患者IMT呈进行性进展,血清hs-CRP水平是影响PROG-IMT的主要因素。Objective To explore the correlation between the micro-inflammatory state of patients of maintenance hemodialysis and progression of carotid intima-media thickness（PROG-IMT）.Methods The high-sensitivity C-reactive protein level（hs-CRP） of 93 standard-compliant MHD patients was measured by ELISA.According to the results,these patients were divided into normal group（30 cases,hs-CRP levels 3 mg/L）,and micro-inflammation group（63 cases,hs-CRP levels 3-15 mg/L）,followed up from June 2008 to May 2011,Color Doppler was used to determine the patients＇ progression of carotid intima-media thickness（twice before and after the experiment）.PROG-IMT was observed and their serum albumin,hemoglobin,blood lipids,blood urea nitrogen,creatinine,calcium,phosphorus,parathyroid hormone,dialysis adequacy,blood pressure were monitored for statistical analysis.Result（1）In micro-inflammation group,there were 56 patients with PROG-IMT.The difference of IMT was statistically significant（P0.05） and positively correlated after the experiment（P0.05）.Five cases died of cardiovascular and cerebrovascular diseases.In normal group,there were 8 patients with PROG-IMT.IMT did not change significantly after the experiment（P0.05）.There was one death from cardiovascular and cerebrovascular diseases.（2） PROG-IMT,hs-CRP,age,blood pressure,and low density lipoprotein were positively correlated（P0.05）.（3） Stepwise multiple regression analysis showed that hs-CRP was a major factor affecting PROG-IMT（P0.05）.Conclusion IMT of MHD patients with micro-inflammatory status is progressive and hs-CRP levels are the main factor that affects PROG-IMT.

关 键 词：微炎症 颈动脉内中膜厚度 进展 血液透析 相关性 

分 类 号：R971.4[医药卫生—药品] R692[医药卫生—药学]