维持性血液透析患者hs-CRP和IL-6与心脏结构功能变化的临床观察

Clinical observation of high sensitivity C-reactive protein and interleukin-6 in relation to changes of cardiac structure and function in maintenance hemodialysis patients

目的探讨维持性血液透析(MHD)患者微炎症状态和心脏结构、功能变化的关系。方法选择徐州医学院第二附属医院血液净化中心维持性血液透析患者共48例,同时设立健康对照组,测定空腹血清中超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)浓度值,通过彩色多谱勒测定患者的心脏结构和功能。结果维持性血液透析组hs-CRP、IL-6、左心室内径(LVD)、左心房内径(LAD)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)水平均显著高于正常对照组(P<0.01),有统计学意义,而2组的左心室射血分数(EF)、E/A的值间差异无统计学意义(P>0.05);血液透析患者hs-CRP、IL-6与LAD、LVD、IVST、LVPWT呈正相关,有80%患者存在舒张功能障碍。结论MHD患者的hs-CRP、IL-6变化与其心脏结构变化有一定相关性。

Objective To investigate the relationship between microinflammation and changes of cardiac structure and function in maintenance hemodialysis （NHD） patients. Methods We recruited 48 patients on mainte-nance hemodialysis in this blood purification center, and 20 normal individuals as the controls. Serum high-sensitivity C-reactive protein （hs-CRP） and interleukin-6 （IL-6） were measured. Cardiac structure and function were evaluated by ultrasonic cardiography. Results Serum hs-CRP, IL-6, left ventricular dimension （LVD）, left atrial dimension （LAD）, interventricular septum thickness （IVST） and left ventricular dimension posterior wall thickness （LVPWT） were sig-nificantly higher in MHD patients than in controls （P〈0.01）. Serum hs-CRP and IL-6 were positively correlated with the values of LAD, LVD, IVST and LVPWT in MHD patients. Doppler echocardiology showed that 80% of the MHD patients had heart diastolic dysfunction. Conclusion MHD patients had higher serum hs-CRP and IL-6, which may correlate with the changes of cardiac structures.