中老年维持性血液透析患者动脉僵硬度与炎症细胞因子及氧化应激的关系  

Carotid atherosclerosis and inflammation and oxidative stress in eldly patients with hemodialysis

作　　者：任红旗[1] 周璇[1] 栾智勇[2] 骆晓梅[3] 韩淑静[1] 蔡青[1] 李艳[1] 李玲[1] 

机构地区：[1]解放军第97医院肾内科,徐州221004 [2]解放军第97医院超声科,徐州221004 [3]解放军第97医院检验科,徐州221004

出　　处：《肾脏病与透析肾移植杂志》2012年第6期536-539,共4页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：南京军区医学创新课题(09MA038)

摘　　要：目的:探讨中老年维持性血液透析(MHD)患者动脉僵硬度与体内微炎症状态及氧化应激之间的关系。方法:采用超声技术测定颈总动脉硬化参数β作为评价大动脉僵硬度指标,根据有无动脉粥样硬化(CAS)将MHD患者分为CAS组和非CAS组。常规检测两组患者血清白蛋白、钙、磷、总胆固醇(CH)、高密度脂蛋白、低密度脂蛋白(LDL)、三酰甘油(TG)、血糖、尿素氮(BUN)、肌酐(SCr)、C反应蛋白等。采用ELISA法检测两组患者血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、8异前列腺素(8-isoprostane)F2α水平。结果:(1)CAS组患者42例,其中男性31例,女性11例,平均年龄57.2±7.8岁(45～73岁),透析龄3～61月(中位数34月);非CAS组患者20例,其中男性12例,女性8例,平均年龄56.2±8.7岁(47～76岁),透析龄3～56月(中位数32月);(2)两组患者在年龄、透析龄、舒张压、BUN、SCr、CH、TG、HDL、LDL、血红蛋白方面无明显差异。CAS组收缩压高于非CAS组(P<0.05);(3)CAS组8-isoprostane水平高于非CAS组[(68.8±45.9)pg/mlvs(25.6±27.5)pg/ml,P<0.01]。两组患者血清C反应蛋白、TNF-α、IL-6水平均高于正常水平,但两组患者无明显差异。结论:本研究表明MHD患者体内普遍存在微炎症状态,炎症因子可能参与动脉硬化形成过程,但高血压和氧化应激所起作用可能更为重要。A Objective：To identify the relationship of arterial stiffness with oxidative stress and micro infalammation state in the middle-age and eldly hemodialysis patients. Methodology：Sixty two cases with maintenance hemodialysis （MHD） were enrolled in this study. Based on the presence or absence of carotid arterial stiffness （CAS） ,they were divided into MHD ＋ CAS group （ n = 42） and simply MHD group （ n = 20）. The carotid atherosclerosis parameters 13 obtained by ultrasound technology was used to assess arterial stiffness. The parameters of albumin （ALB）, calcium （Ca）, serum phosphorus （ P）, total cholesterol （TC）, high density lipoprotein （ HDL）, low-density lipoprotein （ LDL）, triglycerides （ TG serological markers ）, glucose, creatinine, and C-reactive protein were routinely tested in both of the two groups. The levels of TNF-α, IL-6 and 8-isoprostane F2α were measured by ELISA. Results： （ 1 ） In MHD ＋ the CAS group, they were 31 males and 11 females with an age of 45 -73 years old （57.2 ±7.80）, and the dialysis duration of 3 - 61 months （median 34 months）. In the MHD group,they were 12 males and 8 females with an age of 47 -76 years old （56. 2 ±8.7）, and the dialysis duration of 3 -56 months （ median 32 months ）. （2）The respect of age,dialysis duration, the levels of DBP, BUN, Cr, TC, TG, HDL, LDL, and Hb have no significant difference between the MHD ＋ CAS group and MHD group. The level of SBP in the MHD ＋ CAS group was higher than that in the MHD group. （3） The level of 8-isoprostane in the MHD ＋ CAS group was higher than that in the MHD group [ （ 68.8 ± 45.9 ） pg/ml vs （ 25.6 ± 27.5 ） pg/ml, P 〈 0. 01 ] respectively. The levels of hs-CRP,TNF-α,and IL-6 in both groups was higher than that of the normal levels,but they have no statisticaldifference. Conclusion ： We demonstrate that there is a micro inflammation state in MHD patients. The inflammatory factor may lead to atherosclerosis, but hypertension and

关 键 词：血液透析动脉僵硬度炎症细胞因子8异前列腺素 

分 类 号：R459.5[医药卫生—治疗学]