终末期肾脏病患者高同型半胱氨酸血症与心血管并发症的临床分析  

Analysis on homocystinemia and cardiovascular complication in patient with end-stage renal disease

作　　者：鄂静 马丹娜[1,2] 陆艳 杨丽嵘[1,2] 陆晓华 李博 田大成[1,2] 郑亚莉 E Jing;MA Danna;LU Yan;YANG Lirong;LU Xiaohua;LI Bo;TIAN Dacheng;ZHENG Yali(Department of Nephropathy, Ningxia People＇s Hospital, Yinchuan 750002, China;The First Affiliated Hospital of Medical College of Northwest University for Nationalities, Yinchuan 750002, China)

机构地区：[1]宁夏人民医院肾脏内科,宁夏银川750002 [2]西北民族大学第一附属医院,宁夏银川750002

出　　处：《宁夏医学杂志》2018年第3期213-216,共4页Ningxia Medical Journal

基　　金：宁夏自然科学基金项目(NZ16183);西北民族大学中央高校基本科研资金项目(31920160104)

摘　　要：目的分析宁夏人民医院终末期肾脏病(ESRD)患者临床特点,并进一步探讨高同型半胱氨酸血症(Hcy)与心血管并发症的关系。方法回顾性分析106例ESRD患者的临床资料,根据患者是否透析、颈动脉内-中层厚度及粥样斑块进行分组,收集的数据包括患者的基础资料(既往病史、原发病)、生化资料(血红蛋白、白蛋白、血同型半胱氨酸等)及影像学资料(心脏彩超及动脉血管彩超),应用统计学软件SPSS 20.0进行统计学分析。结果 ESRD患者Hcy的发病率为87.6%。维持性血液透析(MHD)组患者血红蛋白、血浆白蛋白水平高于未透析组,但低于正常水平下限,血尿酸和尿素氮水平低于未透析组(P<0.05),其余指标2组间差异均无统计学意义(P>0.05),心血管疾病方面,MHD组动脉硬化的发生率比未透析组高(P<0.05)。颈动脉硬化程度分组结果显示,各组间血常规及生化检验结果均无统计学意义。结论终末期肾脏病患者普遍存在营养不良、低白蛋白血症及Hcy,动脉硬化发生率高,Hcy与动脉硬化疾病未发现明确关系。Objective To analyze homocystinemia and cardiovascular complication in the patients who diagnosed end - stage renal disease （ESRD） in our hospital. Methods Retrospective analysis the clinical data of 116 patients with ESRD were analyzed. And the patients were divided into two groups based on hematodialysis, one group were maintenance hemodialysis （ MHD ） （ n = 67 ）, another group were untreated with renal replacement therapy （ n = 39）. Otherwise, according to the degree of atherosclerosis was divided into no vascular lesion group, thickening of the internal carotid artery and carotid atherosclerosis with plague formation group. The basic data including sex, age, past medical history, biochemical （just like hemoglobin, albumin, homocysteine, uric acid and so on） data and imaging data （ cardiac color ultrasound and artery ultrasound） were collected. Results The chronic glomerulonephritis and diabetic nephropathy were the prior cause of end - stage renal disease in our hospital, the prevalent of Hcy was 87.6% ;The level of hemoglobin and albumin were higher in MHD group than in untreated with renal replacement group, but in abnormal levels, inversely the uric acid and urea nitrogen level were elevated in non - hemodialysis group, there was no significant difference in other data, in cardiovascular aspect, the arteriosclerosis morbidity was higher in MHD group;The blood routine examination and biochemical test especially homocystinemia didn＇t find statistical difference. Conclusion Patients in ESRD are common existed with malnutrition and hyperhomocysteinemia, accomplished with high prevalence of atherosclerosis disease, hyperhomocysteinemia perhaps are not a risk factor for cardiovascular disease in patients with ESRD.

关 键 词：终末期肾脏病 慢性肾脏病5期 血同型半胱氨酸 心血管疾病 

分 类 号：R692[医药卫生—泌尿科学]