炎症与血透患者颈动脉粥样硬化关系的研究

Correlation of Inflammation and Atherosclerosis in Hemodialysis Patients

目的 通过检测超敏C反应蛋白(high -sensitive c- reactive protein, hs- CRP)探讨炎症与血液透析(简称血透)患者颈动脉粥样硬化的关系。方法 选择52例维持性血透患者(HD组)、14 例慢性肾衰竭未透析患者(CRF组)和30 例健康人(C组),采用乳胶增强的免疫浊度法检测hs- CRP质量浓度,并进行高分辨二维颈动脉超声检查,测定颈动脉内中膜厚度,进行相关性分析。结果 HD组、CRF组和C组hs- CRP中位数分别为2.35、0.98和1.43 mg/L,3组之间比较差异具有统计学意义(P=0.026)。HD组中存在颈动脉硬化斑块的血透患者hs CRP质量浓度(2.34 mg/L)显著高于无斑块的患者(0.98 mg/L),P=0.04。多因素逐步Logistic回归分析显示:HD组中hs- CRP和吸烟是发生颈动脉硬化斑块的危险因素。HD组中合并心、脑血管并发症的患者hs CRP质量浓度(6.37 mg/L)显著高于无并发症的患者(1.43 mg/L),P=0.02。结论 多因素逐步Logistic回归分析显示HD组中hs CRP是血透患者发生心、脑血管并发症的危险因素。

Objective To evaluate the relationship between inflammation and atheros clerosis by measuring high sensitive C-reactive protein in hemodialysis patients' blood. Methods The study population included 52 patients with ESRD on hemodialysis(HD group), 14 patients who were close to the start of dialysis treatment(CRF group) and 30 healthy subjects(C group). The high sensitive C-reactive protein(hs-CRP) concentration was detected by the latex-enhanced immunonephelometric assays. All patients and all healthy controls underwent the examination of carotid artery high-resolution B-mode ultrasound. Results The mean hs-CRP level was highest in hemodialysis patients among the three groups(P=0.026). The mean hs-CRP level was higher in patients who have carotid plaques than those who haven't carotid plaques(2.34 mg/L versus 0.98 mg/L, P=0.04). The result of stepwise multiple logistic regression analysis for HD group showed that (α=0.1) only hs-CRP levels and smoke had significant correlation in this model. The mean hs-CRP level was higher in patients with cardiovascular disease than control group(6.37 mg/L versus 1.43 mg/L, P= 0.02). The result of stepwise multiple logistic regression analysis (α=0.1) to determine the independent contribution of each factor to the risk of cardiovascular disease, only hs-CRP levels showed a significant correlation in this model. Conclusion The mean CRP level of hemodialysis patients is increased significantly. It suggests that CRP level was correlated with the progression of atherosclerosis.