PEW对血液透析患者CVD危险因素水平的影响  

Impacts of PEW on levels of CVD risk factors in hemodialysis patients

作　　者：王铁锁 刘华[2] 李冬梅 王莹[3] 

机构地区：[1]三原县医院肾内科血液净化室,陕西三原713800 [2]西安交通大学第一附属医院血液净化科 [3]三原县医院内分泌科,陕西三原713800

出　　处：《西南国防医药》2017年第11期1162-1165,共4页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨蛋白质能量消耗(PEW)对血液透析患者的心血管疾病(CVD)危险因素的影响。方法选取在医院治疗的PEW维持性血液透析的终末期肾病患者33例作为观察组,并选择同期在医院治疗的33例非PEW维持性血液透析的终末期肾病患者作为对照组,比较两组的CVD危险因素水平。结果观察组高敏感C反应蛋白(hs-CRP)和可溶性细胞间粘附分子-1(s ICAM-1)浓度明显高于对照组(P<0.05);两组可溶性血管细胞粘附分子-1(s VCAM-1)、s E-选择素、内皮素-1(ET-1)、脂蛋白(a)[Lp(a)]、丙二醛(MDA)和一氧化氮(NO)浓度无明显差异(P>0.05);有微炎性反应患者的血清s ICAM-1、s VCAM-1、s E-选择素和MDA浓度明显高于无微炎性反应患者(P<0.05);两组ET-1、Lp(a)和NO浓度无显著性差异(P>0.05)。结论 PEW会引起血液透析患者的CVD危险因素hs-CRP和s ICAM-1的升高,可能会增加CVD患病风险。Objective To explore the impacts of protein-energy wasting （PEW） on the levels of cardiovascular disease （CVD） risk factors in hemodialysis patients, Methods A batch of 33 patients with end-stage renal disease to receive PEW maintenance hemodialysis in our hospital were selected to constitute an observation group, and another 33 patients to receive non-PEW maintenance hcmodialysis in our hospital in the corresponding period were selected to constitute a control group. The levels of CVD risk factors between the two groups were compared, Results The concentrations of high-sensitivity C-reactive protein （hs-CRP） and soluble intercellular adhesion molecule-1 （sICAM-1） in the observation group were significantly higher than those in the control group （P 〈 0.05）; the concentrations of soluble vascular cell adhesion molecule-1 （sVCAM-1）, sE-selectin, endothelin-1 （ET-1）, lipoprotein （a） [Lp（a）], malondialdehyde （MDA） and nitric oxide （NO） showed no significant difference between the two groups（P 〉 0.05）; the concentrations of serum sICAM-1, sVCAM-1, sE-selectin and MDA in patients with microinflammatory reactions were much higher than those in the patients without microinflammatory reactions（P 〈 0.05）; the concentrations of ET-1, Lp（a） and NO showed no significant difference between the two groups（P 〉 0.05）. Conclusion PEW can cause the increase of the levels of CVD risk factors hs-CRP and sICAM-1 in hemodialysis patients and may increase the risk of CVD.

关 键 词：蛋白质能量消耗 血液透析 心血管疾病 危险因素 

分 类 号：R692[医药卫生—泌尿科学]