PTX3水平在慢性肾脏病中的意义及与心血管事件危险因素的相关性  

The association of plasma pentraxin 3 in chronic kidney disease and the correlation among traditional risk factors in CVD

作　　者：胡月[1] 刘艳姝[1] 彭玲[1] 

机构地区：[1]佳木斯大学附属第一医院肾内科,黑龙江佳木斯154003

出　　处：《黑龙江医药科学》2017年第1期53-54,57,共3页Heilongjiang Medicine and Pharmacy

基　　金：佳木斯大学研究生科技创新理科面上项目;编号:LM2014_025

摘　　要：目的:探讨慢性肾脏病(CKD)患者血浆五聚素3(pentraxin 3,PTX3)水平与肾小球滤过率(GFR)及与传统心血管事件危险因素的相关性。方法:随机选取无心血管事件的CKD3期患者20例(A组),无心血管事件CKD4期组20例(B组),无心血管事件CKD5期组(C组)20例,在选取同期健康对照组20例(D组),用简化的MDRD公式计算各组的GFR,再将各期在6个月内有无发生心血管事件分为心血管事件组(23例)和非心血管事件组(37例),常规检测各组总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)。酶联免疫法(ELISA)检测白介素6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)水平、N端前脑钠肽(NT-Pro BNP)。结果:A、B、C三组中PTX3明显高于D组(P<0.05),心血管事件组PTX3、hs-CRP、TNF-α、IL-6高于非心血管事件组(P<0.05),相关性分析示PTX3与GFR成负相关(r=-0.46,P<0.01),PTX3与IL-6(r=0.45,P<0.0001)、CRP(r=0.41,P<0.01)、TNF-α(r=0.23,P<0.05)成正相关、PTX3与BNP呈正相关(r=0.497,P<0.01)。高PTX3可导致慢性肾脏病患者的全因死亡率和心血管事件升高,其预测意义优于CRP。结论:CKD患者体内存在广泛的微炎症状态,CKD患者随着GFR的下降PTX3逐渐升高,与微炎症状态和心血管事件的发生相关,PTX3在预测心血管事件和慢性肾脏病患者全因死亡率方面优于传统的危险因素。Objective： To investigate the association of plasma pentraxin 3 in chronic kidney diseases （CKD） and the correlation among traditional risk factors in CVD. （cardiovascular disease）. Methods： Plasma protein pentraxin 3 concentrations were analyzed in relation to GFR, inflammation factors, cardiovascular disease risk factors in 60 patients with stages 3 to 5 non - dialysis chronic kidney disease. Every stage was divided into non - CVD group and CVD group according to cardiovascular event or not in 6 months. 20 control subjects were selected in the same period. Blood serum cholesterol, Triglyceride, HDL with routine measured. PTX3, CRP, TNF - ct, IL - 6, NT - ProBNP were detected by ELISA. Results： The protein pentraxin 3 concentrations in A, B, C groups with chronic kidney disease were higher than in control subjects. PTX3, CRP, TNF -c~, IL -6 were higher in CVD group than non -CVD group. Serum lipids present no relationship within groups. Rl^3 correlated negatively with GFR （r =-0.46,P 〈0.01）,positivelywithIL-6（r = 0.45,P 〈0.01）,hs-CRP（r =0.41,P 〈0.01）,TNF - at （ r = 0.23, P 〈 0. 05 ）. Patients with high protein pentraxin 3 had higher all - cause and cardiovascular mor- tality which was similar to IL - 6 and better than hs - CRP. Conclusion： A constellation of chronic low - grade in- flammation, oxidative stress, and cardiovascular disease are present in a large proportion of patients with advanced chronic kidney disease. Plasma protein pentraxin 3 increases as GFR declines and is associated with the presence of cardiovascular disease. Furthermore, in patient with chronic kidney disease, elevated PTX3 predicted CVD inci- dence was better than traditional risk factors.

关 键 词：血浆五聚素3 慢性肾脏病 心血管事件 微炎症 

分 类 号：R692.5[医药卫生—泌尿科学]