摘要
目的 探讨维持性血液透析患者心外膜脂肪组织与冠状动脉钙化、趋化素的关系。方法 选取天津市第五中心医院维持性血液透析患者90例,依据Framingham危险评分分为低危组(〈10%)、中危组(10%~20%)和高危组(〉20%)。选取60例健康体检者作为对照组。检测血趋化素、C反应蛋白、血常规、血生化,对维持性血液透析患者行胸多层螺旋CT检查,飞利蒲工作站软件测量心外膜脂肪组织体积和冠状动脉钙化评分。分析维持性血液透析患者心外膜脂肪组织体积与冠状动脉钙化评分、趋化素、C反应蛋白、Framingham危险评分等之间的关系。结果 维持性血液透析组血趋化素、C反应蛋白、血中性粒细胞与淋巴细胞比率较对照组升高(P〈0.01);维持性血液透析高危组、中危组心外膜脂肪组织体积、冠状动脉钙化评分、趋化素明显高于低危组(P〈0.05或P〈0.01),高危组心外膜脂肪组织体积、趋化素明显高于中危组(P〈0.05);维持性血液透析患者冠状动脉钙化评分、趋化素、C反应蛋白及Framingham危险评分为心外膜脂肪组织的影响因素(P〈0.05或P〈0.01)。结论 维持性血液透析患者血趋化素、C反应蛋白、血中性粒细胞与淋巴细胞比率升高,维持性血液透析患者存在微炎症状态。维持性血液透析患者高危组、中危组心外膜脂肪组织体积、冠状动脉钙化评分、趋化素均高于低危组,心外膜脂肪组织与维持性血液透析患者冠状动脉钙化评分、趋化素及Framingham危险评分相关,心外膜脂肪组织可预测维持性血液透析患者心血管疾病发生风险。
Aim To explore association of epicardial adipose tissue (EAT) with coronary artery calcification and chemerin in maintenance hemodialysis (MHD) patients. Methods 90 MHD patients in Tianjin Fifth Central Hospital were included in the study. MHD patients were divided into low-risk (〈 10% ), mid-risk ( 10%- 20% ) and high-risk group (〉20%) according to Framingham risk score (FRS). 60 normal subjects were selected as control group. Serum chemerin, C-reactive protein (CRP) , blood routine and biochemistry were determined, multi-slice spinal CT examination were underwent. The EAT volume and coronary artery calcium score (CACS) were calculated with the Philips workstation. The relationship of EAT volume with CACS, serum chemerin, CRP, FRS were analyzed. Results Ser- um chemerin, CRP and neutrophil to lymphocyte ratio were significantly higher in MHD group compared to control group ( all P〈0.01 ). EAT volume, CACS and serum chemerin were significantly higher in high-risk group and in mid-risk group compared to those in low-risk group (P〈0.05 or P〈0.01 ), EAT volume, serum chemerin were significantly higher in high- risk group compared to those in mid-risk group (all P〈0.05 ). The multivariate linear stepwise regression showed that CACS, serum ehemerin, CRP, FRS were the influencing factors of EAT(P〈0.05 or P〈O.01 ). Conclusion Serum chemerin, CRP and neutrophil to lymphocyte ratio were significantly higher in MHD patients. There was microin- flammation in MHD patients. In MHD patients, EAT volume, CACS and serum chemerin in high-risk group and in mid- risk group were both higher than those in low-risk group. CACS, serum ehemerin, FRS were correlated with EAT volume. EAT might be used as predictors of cardiovascular risk in MHD patients.
出处
《中国动脉硬化杂志》
CAS
2018年第2期165-170,共6页
Chinese Journal of Arteriosclerosis
基金
天津市滨海新区塘沽科技兴区项目(2012XQ15-09)