血清炎症指标、同型半胱氨酸与超声心动图在维持血液透析伴或不伴糖尿病肾病患者心肌病变中的相关性分析  

Correlation analysis of serum inflammatory factors,homocysteine and echocardiography in cardiomyopathy in diabetic nephropathy patients on hemodialysis

作　　者：卢海霞 张浩 马宏霞 李沛玲[2] LU Haixia;ZHANG Hao;MA Hongxia;LI Peiling(Department of Nephrology,People′s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China;Department of General Medicine,People′s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China)

机构地区：[1]宁夏回族自治区人民医院肾脏内科,宁夏银川750002 [2]宁夏回族自治区人民医院全科医学科,宁夏银川750002

出　　处：《宁夏医学杂志》2024年第11期953-956,I0001,共5页Ningxia Medical Journal

基　　金：宁夏自然科学基金项目(2022AAC03362);宁夏自然基金项目(2024AACO3503);宁夏医科大学校级项目(XY2024057)。

摘　　要：目的 分析维持血液透析伴糖尿病患者(MHD-DM)与维持血液透析不伴糖尿病患者(MHD)血清炎症指标、血清同型半胱氨酸与超声心动图之间的关系。方法 选取维持血液透析患者115例,分为维持血液透析伴糖尿病(MHD-DM)组(n=32)和维持血液透析不伴糖尿病(MHD)组(n=83),分别检测2组患者血清同型半胱氨酸(Hcy)、β2微球蛋白(β2-MG)、C反应蛋白(CRP)及血沉(ESR)。采用GE Vivid S6型彩色多普勒超声诊断仪,进行常规多普勒超声心动图及二维超声心动图检查。结果 2组患者血清Hcy水平比较,MHD-DM组患者血清Hcy、β2-MG、CRP水平较MHD组明显升高(P<0.05)。MHD-DM组患者室间隔舒末厚度(IVsd)、左室舒末内径(LVDd)、右室前壁厚度(RVAW)、左室前后径(LVs)、左室射血分数(LVEF)等心腔测值均高于MHD组(P<0.05)。左室舒末内径(LVDd)与血清Hcy水平呈正相关(r=0.1928,P<0.05)。结论 维持血液透析伴糖尿病患者血清Hcy和β2-MG水平与左心室肥厚及左心功能下降密切相关,同时血清Hcy水平和β2-MG水平可能在维持血液透析合并糖尿病患者心血管事件发生、发展过程中起着非常重要的促进作用。提示血清Hcy和β2-MG水平可能有助于预测维持血液透析伴糖尿病患者左心室肥厚的严重程度。Objective To analyze the correlation between serum inflammatory factors,homocysteine and echocardiography in maintenance hemodialysis patients and diabetic maintenance hemodialysis patients.Methods A total of 115 patients with maintenance hemodialysis were selected and divded them into maintenance hemodialysis patients with diabetes mellitus(MDD-DM)group(n=32)and maintenance hemodialysis patients without diabetes mellitus(MHD)group( n =83)detect their homocysteine,β2 microglobulin,C-reactive protein and erythrocyte sedimentation rate,respectively.Conventional Doppler echocardiography and two-dimensional echocardiography were performed by GE Vivid S6 color Doppler ultrasound diagnostic instrument. Results The serum Hcy level in the MDD-DM group was significantly higher than that in the MHD group.Serum β2-MG and CRP levels in MDD-DM group were significantly higher than those in MHD group ( P <0.05).Compared with the results of echocardiography between the two groups,the ventricular septal end diastolic thickness (IVsd),left ventricular end diastolic diameter (LVDd),right anterior ventricular wall thickness (RVAW),left anterior and posterior ventricle diameter (LVs) and left ventricular ejection fraction (LVEF) in the MDD-DM group were all higher than those in the MHD group,with statistical significance ( P <0.05).The linear correlation analysis showed that the left ventricular endolumental diameter (LVDd) was positively correlated with serum Hcy level ( r =0.1928, P <0.05). Conclusion The serum Hcy and β2 microglobulin of patients with hemodialysis are closely related to the lower ventricular hypertrophic and the left heart function,while serum Hcy levels and β2 microglobulin levels are likely to play a very important role in the development of cardiovascular events and development in patients with blood dialysis.It is suggested that serum Hcy and β2 microglobulin levels may help predict the severity of the left ventricular hypertrophic in patients with diabetes.

关 键 词：维持血液透析 糖尿病 血清同型半胱氨酸 Β2微球蛋白 超声心动图 

分 类 号：R587.1[医药卫生—内分泌]