慢性肾脏病患者血清可溶性细胞间粘附分子1与颈动脉粥样硬化的关系

The relationship between serum soluble intercellular adhesion molecule-1 and carotid atherosclerosis in chronic kidney disease patients

目的研究慢性肾脏病(chronic kidney disease,CKD)患者血清可溶性细胞间粘附分子1(sICAM-1)的水平与颈动脉粥样硬化之间的关系,同时观察sICAM-1与各生化指标之间的关系。方法 64例CKD患者为CKD组,20例健康体检者为对照组。根据高频B超检测将CKD组分为A组(伴发颈动脉粥样硬化)、B组(不伴发颈动脉粥样硬化)2个亚组,记录颈动脉中层内膜厚度(ITM);并记录患者的其他生化及免疫指标;采用SPSS17.0软件进行所有数据的统计分析。结果 CKD组患者sICAM-1水平明显高于对照组,分别为(432.48±175.42)ng/ml、(286.47±90.11)ng/ml,P<0.01。颈动脉IMT值明显升高,同时血肌酐(Scr)、尿素氮(BUN)、甲状旁腺素(PTH)、甘油三酯(TG)也明显增高,红细胞压积(Hct)、钙(Ca)、白蛋白(Alb)、肾小球滤过率(GFR)明显降低。与不伴发颈动脉粥样硬化组相比,伴发颈动脉粥样硬化组sICAM-1、颈动脉IMT、尿酸(UA)、血磷(P)、总胆固醇(CH)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、超敏C反应蛋白(hs-CRP)、空腹血糖(FPG)差异有统计学意义(P<0.05)。单因素相关分析结果示,CKD患者sICAM-1与颈动脉IMT(r=0.728,P<0.01)、hs-CRP(r=0.689,P<0.01)显著正相关。结论 CKD患者血清sICAM-1明显升高,血清sICAM-1与颈动脉IMT和hs-CRP正相关,并可能与CKD患者是否伴发动脉粥样硬化有关。

Objective To investigate the relationship between serum soluble intercellular molecule-1（sICAM-1） and carotid atherosclerosis in chronic kidney disease （CKD） patients,meanwhile study the relationship between sICAM-1 and other biochemical and immune indicators.Methods 64 CKD patients （CKD group） and 20 healthy volunteers （control group） were studied.According to the result of high-resolution B-mode ultrasonograph the CKD patients were divided into two sub-group：CKD with carotid atherosclerosis（group A）,CKD without carotid atherosclerosis（group B）.The carotid IMT,biochemical and immune characteristics were collected;with SPSS17.0 software for all statistical analysis of date.Results Compared with control group,the sICAM-1 of CKD group was significantly higher[（432.48±175.42）ng/ml vs（286.47±90.11）ng/ml,P0.01],the IMT,Scr,BUN,PTH,TG were also higher,the Hct,Ca,Alb,GFR were lower.The differences of sICAM-1,carotid IMT,UA,P,CH,LDL-C,hs-CRP and FPG between group A and group B were significant（P0.05）.The result of One-Way ANOVA suggested that there were significant positive correlations between sICAM-1 and carotid IMT（r=0.728,P0.01）,hs-CRP（r=0.689,P0.01）.Conclusion sICAM-1 significantly increase in CKD patients.The significant positive correlations between sICAM-1 and IMT,hs-CRP may associate with atherosclerosis in CKD.