带Cuff导管对血液透析患者微炎症状态及颈动脉硬化的影响  

Effects of tunneled cuffed catheter on microinflammatory state and carotid artery atherosclerotic plaque in maintenance hemodialysis patients

作　　者：王革[1] 张萍[1] 杨丽南[1] 徐海霞[1] 董华萍[1] 彭嘉丽[1] 李凤娥[1] 汤锋[1] 

机构地区：[1]解放军第452医院肾内科,四川成都610021

出　　处：《四川医学》2013年第1期33-34,共2页Sichuan Medical Journal

摘　　要：目的探讨经皮下隧道置入带cuff导管对血液透析患者微炎症状态和颈动脉内中膜厚度(IMT)的影响。方法入选患者为我院透析中心维持性血液透析患者54例,选择应用带cuff导管且血液透析两年以上患者24例为导管组,选择应用内瘘且血液透析两年以上患者30例为对照组。测定两组患者超敏C反应蛋白(hsCRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、三酰甘油(TG)、胆固醇(CHO)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、血肌酐(Cr)、尿素氮(Bun)、清蛋白(Alb)、血磷(P)、血钙(Ca)、甲状旁腺素(PTH)、体重指数、彩色超声检查颈动脉IMT。用多元逐步回归法分析IMT与各指标间的相关关系。结果导管组hsCRP、IL-6、TNF-α、IMT、Cr、Alb与对照组差异有统计学意义(P<0.05)。回归分析显示IL-6、TNF-α、hsCRP与颈动脉IMT明显相关,以IL-6的影响最大。结论带cuff导管的血液透析患者存在明显的炎症状态,并且与颈动脉硬化明显相关。Objective To study the effects of cuffed dual-lumen catheter through subcutaneous tunnel on microithrlamma- tory state and the intimar medial thickness（IMT） of the carotid artery in maintenance hemodialysis（MHD） patients. Methods 54 MHD patients in our dialysis center were enrolled and were divided catheter group（24 cases, dialysis by cuffed catheter more than two years） and control groug（ 30 cases, dialysis by arteriovenous fistula more than two years）. The level of parathyroid hormone （PTH） ,creatinine（Cr） ,albumin（Alb） ,serum phosphorus（P） ,triglyceride（TG） ,total cholesterol（CHO） ,low-density lipoprotein cholesterol （ LDL ）, high-density lipoproteins cholesterol （ HDL ）, high-sensitivity C-reactive protein （ bsCRP ）, interleukin-6 （IL-6） ,tumor necrosis factor-α（TNF-α） ,body mass index（BMI） were measured in 54 MHD patients. The intimar medial thick- hess（IMT） of the carotid artery were examed hy ultrasonography. The multiple stepwise regression was used for analyze association of carotid artery with the hsCRP,IL-6 ,TNF-α etc. Results The level of hsCRP ,IL-6 ,TNF-α ,IMT,Cr were significantly higher in catheter group than in control（ P 〈 0. 05 ）. The level of Alb was lower in catheter group than in control （P 〈 0. 05 ）. The carotid ar- tery IMT was independently correlated with IL-6 ,TNF-α ,hsCRP. IL-6 was biggest effect for the carotid artery IMT. Conclusion The MHD patients with cuffed catheter existed mieroinllammatory state and independently correlated with carotid artery atheroscle- rotlc plaque.

关 键 词：带cuff导管 炎症 颈动脉硬化 

分 类 号：R459.5[医药卫生—治疗学]