枸橼酸钠对维持性血液透析患者chemerin2介导的炎症反应和血管内皮细胞损伤的影响  

Effect of sodium citrate on chemerin2 mediated inflammatory response and vascular endothelial cell injury in maintenance hemodialysis patients

作　　者：魏彤 高茗 陈颖 谢继 蒋雨桐 WEI Tong;GAO Ming;CHEN Ying;XIE Ji;JIANG Yutong(Department of Pharmacy,General Hospital of Eastern Theater Command of the People′s Liberation Army of China,Nanjing,Jiangsu 210000,China;Department of Emergency,General Hospital of Eastern Theater Command of the People′s Liberation Army of China,Nanjing,Jiangsu 210000,China)

机构地区：[1]中国人民解放军东部战区总医院药剂科,江苏南京210000 [2]中国人民解放军东部战区总医院急诊科,江苏南京210000

出　　处：《检验医学与临床》2024年第20期3038-3043,共6页Laboratory Medicine and Clinic

基　　金：江苏省卫生健康委员会医学科研立项项目(ZDXKA2021180)。

摘　　要：目的探讨枸橼酸钠对维持性血液透析(MHD)患者视黄酸受体反应蛋白2(chemerin2)介导的炎症反应和血管内皮细胞损伤的影响。方法选取2021年5月至2023年5月在该院进行MHD的98例患者作为研究对象。按照随机数字表法将98例患者分为对照组与观察组,每组49例。对照组采用低分子肝素全身抗凝,观察组采用枸橼酸钠体外局部抗凝。比较两组研究前后血清C-反应蛋白(CRP)、白细胞介素(IL)-6、肿瘤坏死因子-α(TNF-α)、内皮素-1(ET-1)、一氧化氮(NO)、chemerin2、趋化因子样受体1(CMKLR1)、G-蛋白偶联受体1(GPR1)、趋化因子C-C基元受体样蛋白2(CCRL2)水平。采用Pearson相关分析chemerin2水平与炎症因子及血管内皮损伤指标水平的相关性及炎症因子及血管损伤指标水平与CMKLR1、GPR1、CCRL2水平的相关性。结果研究前两组各指标比较,差异均无统计学意义(P>0.05)。研究后两组CRP、IL-6、TNF-α、ET-1、chemerin2水平均高于研究前,NO水平均低于研究后,差异均有统计学意义(P<0.05)。研究后观察组CRP、TNF-α、IL-6、ET-1均低于对照组,NO水平高于对照组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,对照组研究前后chemerin2水平与CRP、IL-6、TNF-α、ET-1水平均呈正相关(P<0.05),与NO水平呈负相关(P<0.05)。观察组研究前chemerin2水平与CRP、IL-6、TNF-α、ET-1水平呈正相关(P<0.05),与NO水平呈负相关(P<0.05),研究后chemerin2水平与CRP、IL-6、TNF-α、ET-1及NO水平均无相关性(P>0.05)。研究后对照组CMKLR1、GPR1、CCRL2水平均高于研究前,差异均有统计学意义(P<0.05)。研究后观察组GPR1、CCRL2水平均高于研究前,CMKLR1水平低于研究前,差异均有统计学意义(P<0.05)。研究后观察组CMKLR1水平低于对照组,差异有统计学意义(P<0.05)。Pearson相关分析结果显示,对照组CMKLR1、GPR1、CCRL2水平研究前后与CRP、IL-6、TNF-α、ET-1水平均呈正相关(P<0.05),与NO水�Objective To explore the effect of sodium citrate on chemerin2 mediated inflammatory response and vascular endothelial cell injury in maintenance hemodialysis(MHD)patients.Methods A total of 98 patients who underwent MHD in this hospital from May 2021 to May 2023 were selected as the research objects.According to the random number table method,98 patients were divided into control group and observation group,49 cases in each group.The control group was treated with low molecular weight heparin systemic anticoagulation,and the observation group was treated with sodium citrate in vitro local anticoagulation.The serum levels of C-reactive protein(CRP),interleukin(IL)-6,tumor necrosis factor-α(TNF-α),endothelin-1(ET-1),nitric oxide(NO),chemerin2,chemokine-like receptor 1(CMKLR1),G-protein coupled receptor 1(GPR1)and chemokine C-C-motif receptor-like protein 2(CCRL2)levels were compared between the two groups before and after the study.Pearson correlation analysis was used to analyze the correlation of chemerin2 level with inflammatory factors and vascular endothelial injury indicators,and the correlation of inflammatory factors and vascular injury indicators with CMKLR1,GPR1 and CCRL2.Results There was no significant difference in each index between the two groups before the study(P>0.05).After the study,the levels of CRP,IL-6,TNF-α,ET-1 and chemerin2 in the two groups were higher than those before the study,and the level of NO was lower than that after the study,and the differences were statistically significant(P<0.05).After the study,the levels of CRP,TNF-α,IL-6 and ET-1 in the observation group were lower than those in the control group,and the level of NO was higher than that in the control group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that the level of chemerin2 before and after study in the control group was positively correlated with the levels of CRP,IL-6,TNF-αand ET-1(P<0.05),and negatively correlated with NO level(P<0.05).In the observation group,

关 键 词：维持性血透 枸橼酸钠 视黄酸受体反应蛋白2 炎症反应 血管内皮损伤 

分 类 号：R459.5[医药卫生—治疗学] R917[医药卫生—临床医学]