高血压肾损伤患者肾血流指标及炎症趋化因子与胰岛素抵抗的关系探究  

Investigation into the relationship between renal blood flow indexes,inflammatory chemokines and insulin resistance of patients with hypertensive renal injury

作　　者：杨震 唐克菲 陈小珠 刘淑军 杜艳华 YANG Zhen;TANG Ke-fei;CHEN Xiao-zhu;LIU Shu-jun;DU Yan-hua(Department of Ultrasound, People′s Hospital of Longhua District, Guangdong Province, Shenzhen 518108, China;Department of Cardiovascular Medicine, People′s Hospital of Longhua District, Guangdong Province, Shenzhen 518108, China)

机构地区：[1]广东省深圳市龙华区人民医院超声科,广东深圳518108 [2]广东省深圳市龙华区人民医院心血管内科,广东深圳518108

出　　处：《河北医科大学学报》2021年第12期1397-1400,1410,共5页Journal of Hebei Medical University

基　　金：深圳市科技创新分项资金(1030291)。

摘　　要：目的探究高血压肾损伤患者肾血流指标及炎症趋化因子与胰岛素抵抗的关系。方法选取高血压肾损伤患者80例为观察组,同时期的80例高血压无肾损伤患者为对照组。检测与比较2组的肾血流指标及炎症趋化因子(血清趋化因子配体2、CXC类趋化因子配体10、白细胞介素8)水平,并比较观察组中不同胰岛素抵抗指数(homa-insulin resistance homa-index,HOMA-IR)者的肾血流指标及炎症趋化因子水平,采用Spearman秩相关分析,肾血流指标及炎症趋化因子与胰岛素抵抗的关系。结果观察组的肾段动脉及肾叶间动脉收缩期峰值流速(peak velocity of the systolic wave,Vs)、舒张期末流速(end diastolic peak flow velocity,Vd)显著低于对照组,肾段动脉及肾叶间动脉阻力指数(resistance index,RI)及搏动指数(pulsatility index,PI)及炎症趋化因子显著高于对照组,观察组中不同HOMA-IR者的肾血流指标及炎症趋化因子比较,差异有统计学意义(P<0.05),Spearman秩相关分析显示,肾段动脉及肾叶间动脉Vs及Vd与胰岛素抵抗呈负相关,肾段动脉及肾叶间动脉RI、PI及炎症趋化因子与胰岛素抵抗呈正相关(P<0.05)。结论高血压肾损伤患者的肾血流指标及炎症趋化因子显著异常,且与胰岛素抵抗有密切的关系,因此应重视对上述指标的检测与调控。Objective To investigate the relationship between renal blood flow indexes,inflammatory chemokines and insulin resistance of patients with hypertensive renal injury.Methods A total of 80 patients with hypertensive renal injury were chosen as the observation group,and in the meantime,80 patients with hypertension and without renal injury were chosen as the control group.The renal blood flow indexes and inflammatory chemokines(serum CCL-2,CXCL-10 and IL-8)of two groups were detected and compared,and the renal blood flow indexes and inflammatory chemokines of observation group with different insulin resistance index were compared.The relationship between renal blood flow indexes,inflammatory chemokines and insulin resistance was analyzed with Spearman rank correlation analysis.Results Peak velocity of the systolic wave(Vs)and end diastolic peak flow velocity(Vd)of the segmental renal artery and interlobar renal artery were significantly lower in the observation group than in the control group,while resistance index(RI),pulsatility index(PI)and inflammatory chemokines of the segmental renal artery and interlobar renal artery were significantly higher than those of control group;the renal blood flow indexes and inflammatory chemokines of observation group with different insulin resistance indexes were compared,and there were statistically significant differences(P<0.05).The Spearman rank correlation analysis showed that Vs and Vd of the segmental renal artery and interlobar renal artery were negatively correlated with insulin resistance,while the segmental renal artery and interlobar renal artery RI,PI and inflammatory chemokines were positively correlated with insulin resistance(P<0.05).Conclusion The renal blood flow indexes and inflammatory chemokines of patients with hypertensive renal injury are significantly abnormal,which are all closely associated with insulin resistance.Thus,detection and regulation of those indexes should warrant attention.

关 键 词：肾损伤 肾循环 炎症趋化因子 

分 类 号：R692.5[医药卫生—泌尿科学]