血小板源性生长因子BB与血液透析患者颈动脉粥样硬化的关系  

The relationship of platelet derived growth factor-BB and carotid atherosclerosis in maintenance hemodialysis patients

作　　者：曾宇然[1] 王伟鸿[1] 卢敏[1] 严丽君[1] 

机构地区：[1]汕头大学医学院第一附属医院血液净化科,515041

出　　处：《中国医师进修杂志》2013年第28期10-13,共4页Chinese Journal of Postgraduates of Medicine

基　　金：广东省汕头市重点科技计划[2011（39号）]

摘　　要：目的测定血液透析患者血浆血小板源性生长因子BB（PDGF—BB）水平，探讨其在血液透析患者颈动脉粥样硬化发生发展中的意义。方法选择36例维持性血液透析患者作为试验组及性别、年龄相匹配的20例健康体检者作为健康对照组，采用酶联免疫吸附试验法测定两组血浆PDGF-BB水平，同时应用彩色多普勒超声显像仪检查两组颈动脉内膜-中层厚度（IMT）及所探测到的斑块情况，并进行统计学分析。结果试验组颈动脉IMT为（1．01±0．23）mm，颈动脉粥样硬化阳性率为69．4％（25D6）；健康对照组颈动脉IMT为（0．72±0．15）mm，颈动脉粥样硬化阳性率为10．0％（2／20）。试验组颈动脉IMT及颈动脉粥样硬化阳性率均显著高于健康对照组，差异有统计学意义（P〈0．01）。试验组血浆肌酐、白蛋白、总胆固醇较健康对照组显著增高[（1991．8±228．6）μmol／L比（71．2±15．9）μmol／L、（36．78±3．40）g／L比（41．96±2．07）g／L、（4．97±0．57）mmol／L比（4．48±0．84）mmol／L]，差异有统计学意义（P〈0．01或〈0．05）。试验组血浆PDGF—BB水平显著高于健康对照组[（93．27±31．58）ng／L比（31．71±15．78）ng／L]，差异有统计学意义（P〈0．01）。试验组中颈动脉粥样硬化阳性患者年龄、血浆PDGF-BB及三酰甘油水平均高于颈动脉粥样硬化阴性患者[（48．04±9．97）岁比（34．54±10．35）岁、（102．60±32．87）ng／L比（72．06±13．67）ng／L、（1．51±0．59）mmol／L比（1．01±0．27）mmol／L]，差异有统计学意义（P〈0．01）。回归分析显示，年龄（β=0．346，P〈0．01）、PDGF-BB（β=0．594，P〈0．01）为影响IMT的重要因素。结论血液透析患者血浆PDGF-BB水平明显增高，其对颈动脉粥样硬化的发生有重要作用。Objective To measure the level of platelet derived growth factor-BB （PDGF-BB） in maintenance hemodialysis patients and investigate the significance of carotid atherosclerosis. Methods Thirty-six maintenance hemodialysis patients （test group） and 20 healthy controls （normal control group） were enrolled in this study. The level of PDGF-BB was measured by enzyme-linked immunosorbent assay in two groups. Intima-media thickness （IMT） and atherosclerotic plaques of the extracranial common carotid artery were measured by echocardiography. Results The level of IMT and the positive rate of carotid atherosclerosis in test group were significantly higher than those in normal control group [ （1991.8 ± 228.6 ） μmol/L vs. （71.2 ± 15.9 ） μmol/L, （ 36.78 ± 3.40） g/L vs. （41.96 ± 2.07 ） g/L, （4.97 ± 0.57 ） mmol/L vs. （4.48 ±0.84） mmol/L][（1.01 ±0.23） mm vs. （0.72 ±0.15） mm,69.4%（25/36） vs. 10.0%（2/20）]（P〈 0.01 ）. The level of plasma creatinine, albumin and total cholesterol in test group were significantly higherthan those in normal control group （P 〈 0.01 or 〈 0.05 ）. The level of PDGF-BB in test group was significantly higher than that in normal control group [ （ 93.27 ± 31.58 ） ng/L vs. （ 31.71 ± 15.78 ） ng/L, P 〈 0.01 ]. In test group, age and the level of PDGF-BB and triacylglycerol in carotid atherosclerosis patients were significantly higher than those in non-carotid atheroselemsis patients [ （48.04 ± 9.97 ） years vs. （34.54 ± 10.35 ） years, （ 102.60 ± 32.87 ） ng/L vs. （72.06 ± 13.67 ） ng/L, （ 1.51 ± 0.59 ） mmol/L vs. （ 1.01 ± 0.27 ） mmol/L] （P 〈 0.01 ）. Regression analysis showed that age （ β = 0.346,P 〈 0.01 ） and PDGF-BB （ β = 0.594,P 〈 0.01 ） were the important impacting factors for IMT. Conclusion The level of PDGF-BB is increased in maintenance hemodialysis patients, and it may play an important role in carotid athemsc｜erosis.

关 键 词：透析 血小板源性生长因子 动脉粥样硬化 

分 类 号：R459.5[医药卫生—治疗学]