血浆五聚素3与慢性肾脏病非透析患者心血管疾病的相关性

Correlation of Pentraxin 3 with cardiovascular disease in chronic kidney disease

目的探讨血浆五聚素3（pentraxin3，PTX3）水平与慢性肾脏病（CKD）非透析患者心血管疾病（cardio vascular disease，CVD）的关系。方法选择CKD3～5期非透析患者90例分为CKD非CVD组（A组，58例）和CKD合并CVD组（B组，32例）；另选健康正常者15名为健康对照组。收集CKD患者临床资料、相关生化指标。用放免法测定PTX3、超敏C反应蛋白（hs—CRP）及彩超测定颈动脉内膜中层厚度（IMT）。采用ROC曲线分析PTX3、hs—CRP与CVD的相关性。相关性分析采用Pearson相关分析法。结果①A、B组PTX3、hS-cRP等炎症介质均明显高于健康对照组（P〈0．05）。②B组PTX3、hs—CRP均明显高于A组（P〈0．05）。③针对CⅧ的ROC曲线分析显示，PTX3与CKD患者的CVD关系更为密切，PTX3曲线下面积为0．860（P〈0．01），当检测的截点为6．73μg／L时，其敏感性为75％，特异性为89．7N；hs—CRP曲线下面积为0．622（P〈0．05），当检测的截点为11．23mg／L时，其敏感性为62．5％，特异性为55．2％。④A、B组IMT均明显高于健康对照组（P〈0．05）。B组比A组IMT呈逐渐增厚趋势，但无统计学意义（P〉0．05）。IMT与PTX3呈正相关（r=0．372，P〈0．05）。结论CKD患者体内都存在炎症状态，PTX3、hs—CRP均高于健康人。与CRP相比，PTX3与CKD患者的CVD关系更为密切。它可作为CKD患者CVD的危险因素观察指标之一。

Objective To investigate the correlation between plasma levels of Pentraxin 3 （PTX3） and cardiovascular disease （CVD） in patients with chronic kidney disease. Methods Ninety patients with chronic kidney disease （stages 3-5） were divided into two groups： non-CVD group A （n = 58） and CVD group B （n = 32）. Fifteen healthy volunteers served as control group. Clinical data were collected for analysis. PTX3 and high-sensitive C-reactive protein （hs-CRP）were determined. Carotid intima thickness （IMT） was measured by carotid ultrasound. Receiver operator characteristic （ROC） curve was used to analyze the correlation among PTX3, hsCRP and CVD. Results Plasma PTX3 and hsCRP levels were significantly higher in group 13 than those in group A and control group. ROC curve analysis showed PTX3 was more closely correlated to CVD than hs-CRP in group B. ROC curve of CVD revealed that area under the curve of PTX3 was 0. 860 （P〈0. 01）, and that of hs-CRP was 0. 622 （P〈0. 05）. With the cut-off value of PTX3 as 6. 73μg/L, the diagnostic sensitivity and specificity in CVD was 75% and 89.7% respectively. With the cut-off value of hs-CRP as 11.23 rag/L, the diagnostic sensitivity and specificity in CVD was 62. 5% and 55.2% respectively. Plasma PTX3 was found to be positively associated with IMT （r = 0. 372, P〈0. 05）. Conclusions Chronic inflammation exists in patients with chronic kidney disease. Plasma PTX3 and hs-CRP levels were significantly higher in chronic kidney disease than those in control group. Plasma PTX3 is more related to CVD than hs-CRP in chronic kidney disease with CVD, and it can be a useful marker of CVD risk factors in chronic kidney disease.