维持性血液透析患者同型半胱氨酸超敏C反应蛋白及肿瘤坏死因子与动脉粥样硬化关系

Study on the correlation between homocysteine,hypersensitivity C-reactive protein,tumor necrosis factor and atherosclerosis in the maintenance hemodialysis patients

目的探讨维持性血液透析患者同型半胱氨酸、超敏C反应蛋白、肿瘤坏死因子与动脉粥样硬化关系。方法测定40例1年以上透析充分的维持性血液透析(MHD)患者透析前同型半胱氨酸(Hcy)、超敏C反应蛋白(hsCRP)、肿瘤坏死因子α(TNF-α)、血肌酐(Scr)、血尿酸(UA)、血糖(Glu)、血浆白蛋白(ALB)、血甘油三酯(TG)、胆固醇(TC)。应用超声测定颈动脉中层厚度(MT)及有无颈动脉斑块形成。结果IMT增厚和(或)有斑块形成组Hcy、hsCRP、TNF-α明显高于非增厚组,两组之间差异有显著性(P<0.05),而两组在收缩压、脉压、血TC、TG、血糖、血尿酸无统计学差异。结论血Hcy、hsCRP、TNF-α的升高可以作为MHD患者动脉粥样硬化的独立危险因素。

Objeαive To evaluate the correlation between homocysteine（ Hcy）, hypersensitivity C-reaαive protein （hsCRP） , tumor necrosis faαor-ix （TNF-α） and atherosclerosis （AS） in the maintenance hemodialysis patients （MHD）. Methods The level of Hey, hs-CRP, TNF-α,serum creatinine, serum uric acid, glucose, albumin, triglyceride （TG） and total cholesterol （TC） were measured from 40 patients who had more than 1 years maintenance hemodialysis history. Intima-medial thickness of carotid arteries and the presence of atherosclerotic plaque were measured by ultrasonography. Results In MHD with AS group the level of serum Hey, hsCRP and TNF-α was significantly higher than that without AS. The difference between the two groups was statistically significance （P 〈 0. 05）. Meanwhile, there was no significant differences on serum TC, TG, blood pressure, pulse pressure, glucose, albumin and uric acid between two groups. Conclusion The increased level of serum Hcy, hsCRP and TNF-α could be used as independent dangerous faαors for AS in MHD patients.