血浆同型半胱氨酸及白细胞水平与终末期肾病患者合并主动脉夹层的相关性研究

Study on the correlation between plasma homocysteine and white blood cell levels and aortic dissection in patients with end-stage renal disease

目的探讨血浆同型半胱氨酸及白细胞(WBC)水平与终末期肾病(ESRD)患者合并主动脉夹层(AD)的关系。方法回顾性分析2011年1月~2018年12月在赣南医学院第一附属医院与赣州市人民医院诊断为AD的125例患者的临床资料,其中ESRD合并AD 22例(作为ESRD夹层组),分别为肾性ESRD 16例,糖尿病ESRD 2例,高血压ESRD 4例;肾功能正常的AD 103例(作为肾功能正常夹层组)。检测两组患者的血浆同型半胱氨酸(Hcy)、血肌酐(SCr)、肾小球滤过率(GFR)、WBC水平,并分析Hcy与SCr、GFR及WBC的关系。结果ESRD夹层组患者的SCr、Hcy水平分别为(927.72±465.30)、(23.89±12.16)μmol/L,均明显高于肾功能正常夹层组的(76.71±16.51)、(16.79±9.32)μmol/L,差异有统计学意义(P<0.05)。ESRD夹层组患者的GFR及WBC水平分别为(9.93±9.01)ml/(min·1.73 m^2)、(8.05±2.94)×10^9/L,均明显低于肾功能正常夹层组的(106.33±15.06)ml/(min·1.73 m^2)、(10.89±3.55)×10^9/L,差异有统计学意义(P<0.05)。相关性分析结果显示,Hcy与SCr成正相关(r=0.18,P<0.05),GFR与Hcy成负相关(r=-0.24,P<0.01),WBC计数与Hcy无相关性(r=0.04,P=0.62)。结论血浆高Hcy可能参与ESRD患者AD的发生,提示降低Hcy水平可能成为预防ESRD患者发生AD的一个有效措施。

Objective To explore the relationship between plasma homocysteine and white blood cell(WBC)levels and aortic dissection(AD)in patients with end-stage renal disease(ESRD).Methods The clinical data of 125 patients with AD diagnosed in the First Affiliated Hospital of Gannan Medical University and People′s Hospital of Ganzhou City from January 2011 to December 2018 were retrospectively analyzed.There were 22 cases of ESRD with AD(used as the ESRD dissection group),including 16 cases of kidney disease related to ESRD,2 cases of diabetes mellitus related to ESRD,4 cases of hypertension related to ESRD,and the remaining 103 cases were patients with normal renal function combined with AD(used as the normal renal function dissection group).The plasma homocysteine(Hcy),serum creatinine(SCr),glomerular filtration rate(GFR),and WBC levels were measured in both groups and the relationship between Hcy and SCr,GFR,WBC was analyzed.Results The levels of SCr and Hcy in the ESRD dissection group were(927.72±465.30)and(23.89±12.16)μmol/L,respectively,which were significantly higher than those in the normal renal function dissection group for(76.71±16.51)and(16.79±9.32)μmol/L,and the differences were statistically significant(P<0.05).The GFR and WBC levels in the ESRD dissection group were(9.93±9.01)ml/(min·1.73 m^2)and(8.05±2.94)×10^9/L,respectively,which were significantly lower than those in the normal renal function dissection group for(106.33±15.06)ml/(min·1.73 m^2),(10.89±3.55)×10^9/L,and the differences were statistically significant(P<0.05).Correlation analysis showed that Hcy was positively correlated with SCr(r=0.18,P<0.05),GFR was negatively correlated with Hcy(r=-0.24,P<0.01),and WBC count was not correlated with Hcy(r=0.04,P=0.62).Conclusion High plasma Hcy may be involved in the occurrence of AD in patients with ESRD,suggesting that lowering Hcy levels may be an effective measure to prevent AD in patients with ESRD.