维持性血液透析患者血管反应性充血指数与心血管风险因子相关性研究

Vascular reactive hyperemia index and certain cardiovascular risk factors in maintenance hemodialysis patients

目的:探讨维持性血液透析患者血管内皮功能指标血管反应性充血指数(RHI)与部分心血管风险因子之间的相关性。方法:选取维持性血液透析患者70例,采用Endo-PAT 2000仪器测定患者外周动脉张力(PAT)并计算RHI,同时选取30例健康体检者测量RHI;收集70例患者的一般临床资料,放射免疫法测量患者i PTH水平,同时检测患者Ca、P、CRP、BNP、NTpro BNP、Troponin I、Troponin T等水平,并进行单因素相关分析,得出有相关性的因子后进一步做多因素回归分析。结果:(1)维持性血液透析患者RHI水平明显低于健康对照者(P<0.01);(2)维持性血液透析患者RHI与血磷水平呈正相关(P<0.01),与血钙水平呈负相关(P<0.01)。结论:维持性血液透析患者存在内皮功能障碍,钙磷代谢失衡可能是维持性血液透析患者内皮功能障碍的主要影响因素。

Objective ： To investigate the correlation between vascular reactive hyperemia index（RHI） and certain cardiovascular risks in patients undergoing maintenance hemodialysis. Methods： Seventy patients undergoing maintenance hemodialysis were enrolled. Endothelin peripheral arterial tonometry （PAT） 2000 was used to measure the peripheral arterial tension （PAT） and RHI. Another 30 healthy subjects undergoing physical examination were recruited as controls to measure corresponding RHI. Radioimmunoassay was performed to measure the level of intact parathyroid hormone （iPTH）. The levels of Ca, P, CRP, BNP, NTproBNP, Troponin I and Troponin T were also detected and analyzed by single factor correlation analysis. The factors related to factors were analyzed by factorial regression analysis. Results ： （1） The level of RHI in maintenance hemodialysis patients was significantly lower than that in healthy controls （ P〈 0. 01 ） ; （2） RHI was positively correlated with serum phosphorus level （ P 〈 0. 01 ） , yet negatively with serum calcium （ P 〈 0. 01 ）. Conclusion ： Endothelial dysfunction exists in patients undergoing maintenance hemodialysis. The major factors leading to the dysfunction may be associated with imbalance of calcium and phosphorus metabolism.