维持性血液透析患者血清胱抑素C、微炎症状态、颈动脉内膜中层厚度间的关系  

Correlation among the serum cystatin C level,microinflammation state and carotid intimal medial thickness in maintenance hemodialysis patients

作　　者：周娲[1] 邹宏昌[1] 杨丽萍[2] 涂卫平[1] 徐承云[1] 徐高四[1] 章春泉[1] 房向东[1] 

机构地区：[1]南昌大学第二附属医院,南昌330006 [2]江西省第二人民医院

出　　处：《山东医药》2013年第1期21-23,共3页Shandong Medical Journal

摘　　要：目的探讨维持性血液透析(MHD)患者血清胱抑素C(CysC)水平、微炎症状态、颈动脉内膜中层厚度(CIMT)之间的关系。方法选择MHD患者100例(MHD组)和健康对照者60例(正常对照组)为研究对象。采用彩色多谱勒超声测定两组CIMT,根据CIMT将无斑块形成的70例MHD患者随机分为A组:CIMT≤0.60 mm;B组:0.79 mm>CIMT>0.61 mm;C组:CIMT≥0.80 mm。采用免疫浊度法检测血清CysC水平;速率散射比浊法检测血清超敏C反应蛋白(hs-CRP)水平;ELISA法检测血清淀粉样蛋白(SAA)水平。结果 MHD组血清CysC、hs-CRP、SAA水平及CIMT明显高于正常对照组(P均<0.05);MHD患者A组血清CysC、hs-CRP、SAA水平较B组及C组明显下降(P均<0.05),B组上述因子水平较C组明显降低(P均<0.05);相关分析结果提示,MHD组血清CysC水平与血清hs-CRP、SAA水平及CIMT呈正相关(r分别为0.571、0.477、0.849,P均<0.05),CIMT与血清hs-CRP及SAA水平呈正相关(r分别为0.72、0.519,P均<0.05),多因素逐步回归分析显示,CIMT与血清CysC、hs-CRP呈正相关(β分别为0.637、0.279,P均<0.05)。结论 MHD患者心血管事件的高发生率可能与血清CysC升高及微炎症状态有关。血清CysC可能是MHD患者出现心血管事件并发症的危险因素之一。Objective To study the correlation among the serum cystatin C （CysC） level, microinflammation state and carotid intimal medial thickness （CIMT） in maintenance hemodialysis （MHD）patients. Methods Totally 100 MHD pa- tients （MHD group） and 60 healthy subjects （normal control group） were enrolled. CIMT was measured by carotid artery color doppler ultrasound in the two groups. 70 patients of MIlD group without plaque formation were divided into three group according to CIMT. Group A： CIMT~〈0.60 mm, group 13 ： 0.79 mm〉 CIMT 〉 0.61 ram, group C ： CIMT t〉0.80 mm. The serum levels of CysC, high sensitivity C-reative protein（hs-CRP）, serum amyloid A（SAA） and C1MT were de- tected in each group. Results The serum levels of CysC, hs-CRP, SAA and CIMT were significantly higher in MHD group compared with those of normal control group （ all P 〈 0.05 ）. The CysC, hs-CRP and SAA levels in group A were ob- viously lower than those in group B and group C （ all P 〈 0.05 ）. The levels of those factors were significantly lower in group B than in group C. Correlation analysis results displayed that CysC was positively correlated with hs-CRP, SAA and CIMT in MHD group （ r = 0.571, r = 0.477, r = 0.849, all P 〈 0.05） , CIMT was positivdy correlated with hs-CRP and SAA （ r = 0.72, r = 0. 519, all P 〈 0.05）. Multiple stepwise regression analysis results displayed ： CIMT was positively correlated with CysC and hs-CRP（fl = 0. 637, ~ = 0. 279, all P 〈 0.05 ）. Conclusion High incidence of risk of cardiovascalar events in MIlD patients may related to the increase of serum CysC and microinflammatiou state. Serum CysC may be one of the risk factors of cardiovascular events in MHD patients.

关 键 词：血液透析 胱抑素C C反应蛋白质 淀粉样蛋白AA 

分 类 号：R459.5[医药卫生—治疗学]