维持性血液透析患者血清趋化素水平与心外膜脂肪组织体积和冠状动脉钙化的关系

Relationship between serum chemerin level and epicardial adipose tissue volume and coronary artery calcification in maintenance hemodialysis patients

目的研究维持性血液透析患者血清趋化素水平与心外膜脂肪组织体积和冠状动脉钙化的关系。方法选取从2015年2月~2018年2月阜阳市第二人民医院收治的96例维持性血液透析患者为研究组。另取同期体检健康者50名为对照组。比较两组人员各项生化指标水平。同时,将研究组患者按照Framingham危险评分分为低危组50例、中危组27例及高危组19例,分别比较三组患者心外膜脂肪组织体积、冠状动脉钙化评分以及血清趋化素水平,并作相关性分析。结果研究组趋化素、中性粒细胞百分比、中性粒细胞/淋巴细胞、C反应蛋白、尿素、肌酐、空腹血糖水平均高于对照组,血小板计数低于对照组,差异有高度统计学意义(P<0.01)。低危组、中危组、高危组患者的心外膜脂肪组织体积、冠状动脉钙化评分以及血清趋化素水平均呈逐渐升高趋势,差异均有高度统计学意义(P<0.01)。维持性血液透析患者血清趋化素水平与心外膜脂肪组织体积、冠状动脉钙化评分均呈正相关(r=0.713、0.689,P<0.05)。结论维持性血液透析患者血清趋化素升高,与心外膜脂肪组织及冠状动脉钙化密切相关,检测血清趋化素可以预测患者心血管疾病发生的风险。

Objective To study the relationship between serum chemerin and epicardial adipose tissue volume,coronary artery calcification in maintenance hemodialysis patients.Methods From February 2015 to February 2018,96 patients with maintenance hemodialysis admitted to NO.2 People′s Hospital of Fuyang City were selected as the study group.Another 50 healthy persons who received physical examination in the same period were recorded as control group.The levels of biochemical indexes in the two groups were compared.At the same time,the study group was divided into low-risk group(50 cases),medium-risk group(27 cases)and high-risk group(19 cases)according to Framingham risk score.The volume of epicardial adipose tissue,coronary artery calcification score and serum chemerin level in the three groups were compared,and the correlation analysis was made.Results The levels of chemerin,neutrophil percentage,neutrophils/lymphocytes,C-reactive protein,urea,creatinine,fasting blood glucose in the study group were higher than those in the control group,the platelet count was lower than that in the control group,the differences were highly statistically significant(P<0.01).The volume of epicardial adipose tissue,coronary artery calcification score and serum chemerin level in low-risk group,medium-risk group and high-risk group showed a gradual increase trend,the differences were highly statistically significant(P<0.01).The serum chemerin level of maintenance hemodialysis patients was positively correlated with the volume of epicardial adipose tissue and coronary artery calcification score(r=0.713,0.689,P<0.05).Conclusion The elevation of serum chemerin in maintenance hemodialysis patients is closely related to epicardial adipose tissue and coronary artery calcification.Detection of serum chemerin can predict the risk of cardiovascular disease in patients.