维持性血液透析与腹膜透析患者中血清碱性磷酸酶、超敏肌钙蛋白I的表达水平及对心脏结构的影响

Expression of serum alkaline phosphatase and high-sensitivity cardiac Troponin I in patients on maintenance hemodialysis and peritoneal dialysis and its influence on cardiac structure

目的 研究维持性血液透析与腹膜透析患者中血清碱性磷酸酶(ALP)、超敏肌钙蛋白I (hs-cTnI)的表达水平及对心脏结构的影响。方法 回顾性分析2018年1月至2020年5月安康市中医医院肾病科收治的86例行透析治疗患者的临床资料,根据透析方式不同分为维持性血液透析组(n=42)和腹膜透析组(n=44)。比较两组患者治疗前后的血清ALP、hs-cTnI水平和治疗前后的心脏结构变化。结果 两组患者治疗后的血清hs-cTnI和ALP水平均明显低于治疗前,且腹膜透析组患者治疗后的血清hs-cTnI和ALP水平分别为(70.44±5.89) ng/mol和(50.14±5.44) U/L,明显低于维持性血液透析组的(90.54±5.44) ng/mol和(70.93±5.56) U/L,差异均具有统计学意义(P<0.05);两组患者治疗后的LVEDD、LAD、LVPWDT均明显高于治疗前,且腹膜透析组患者治疗后的LVEDD、LAD和LVPWDT分别为(46.89±1.89) mm、(42.55±5.08) mm和(15.55±1.23) mm,明显高于维持性血液透析组的(43.54±1.44) mm、(37.21±5.19) mm和(12.54±1.35) mm,差异均具有统计学意义(P<0.05)。结论 维持性血液透析和腹膜透析对患者的血清ALP、hs-cTnI水平及心脏结构均存在一定的影响,但腹膜透析治疗对患者改善程度更大。

Objective To study the expression of serum alkaline phosphatase(ALP) and high-sensitivity cardiac troponin I(hs-cTnI) levels in patients on maintenance hemodialysis and peritoneal dialysis and their effects on cardiac structure. Methods The clinical data of eighty-six patients undergoing dialysis in Department of Nephrology, Ankang Hospital of Traditional Chinese Medicine from January 2018 to May 2020 were retrospectively analyzed, and patients were classified into maintenance hemodialysis group(n=42) and peritoneal dialysis group(n=44) according to the dialysis methods. Serum levels of ALP and hs-cTnI, and the cardiac structure were compared between the two groups at the baseline and after treatment. Results After treatment, serum levels of ALP and hs-cTnI were decreased in both groups, and the levels of two indicators were(70.44±5.89) ng/mol and(50.14±5.44) U/L in peritoneal dialysis group,which were significantly lower than(90.54±5.44) ng/mol and(70.93±5.56) U/L in maintenance hemodialysis group(P<0.05). After treatment, the left ventricular end-diastolic dimension(LVEDD), left atrial diameter(LAD), and left ventricular posterior wall end-diastolic thickness(LVPWDT) were increased in both groups, and the values of three parameters were(46.89±1.89) mm,(42.55±5.08) mm, and(15.55±1.23) mm in peritoneal dialysis group, which were significantly higher than(43.54±1.44) mm,(37.21±5.19) mm, and(12.54±1.35) mm in maintenance hemodialysis group(P<0.05). Conclusion Both peritoneal dialysis and maintenance dialysis have impact on serum ALP and hs-c Tn I levels and cardiac function of patients, while peritoneal dialysis results in greater clinical improvement than maintenance dialysis.