慢性肾脏病患者五聚素3与血管内皮功能障碍的相关性研究

发布时间：2018-05-07 08:05

  本文选题：肾病 + 内皮细胞　； 参考：《中国全科医学》2017年12期

【摘要】：目的探讨慢性肾脏病(CKD)未透析患者五聚素3(PTX3)与血管内皮功能障碍的关系。方法选取2012年4月—2013年12月在首都医科大学附属北京朝阳医院肾内科住院或门诊治疗的符合纳入标准的CKD患者70例,采用简化MDRD公式计算估算肾小球滤过率(e GFR),并根据e GFR将患者分为CKD 1~3期组(A组,n=30)和CKD 4~5期组(B组,n=40)。另选取同期在首都医科大学附属北京朝阳医院体检中心体检健康者30例为对照组。采用ELISA法检测血清PTX3,采用外周动脉张力检测技术检测反应性充血指数(RHI)。收集3组一般资料[性别、年龄、糖尿病发生率、高血压发生率、吸烟率、收缩压(SBP)、舒张压(DBP)、脉压(PP)、平均动脉压(MAP)、体质指数(BMI)]、实验室检查指标[白细胞计数(WBC)、中性粒细胞分数(NE)、血红蛋白(HGB)、清蛋白(ALB)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、尿素氮(BUN)、血肌酐(Scr)、尿酸(UA)、血钙、血磷、全段甲状旁腺激素(PTH)]、炎性指标[超敏C反应蛋白(hs-CRP)、PTX3]、血管内皮功能指标(内皮素、RHI),并分析CKD患者PTX3与各指标的相关性。结果 A组SBP、MAP高于对照组(P0.05);B组SBP、PP、MAP高于对照组、A组,DBP高于对照组(P0.05)。A组NE、LDL-C、UA高于对照组,HGB、ALB低于对照组(P0.05);B组NE、BUN、Scr、血磷、PTH高于对照组、A组,HGB、血钙低于对照组和A组,ALB低于对照组,LDL-C、UA高于对照组(P0.05)。A组PTX3高于对照组,RHI低于对照组(P0.05);B组hs-CRP、PTX3、内皮素高于对照组、A组,RHI低于对照组、A组(P0.05)。Pearson相关性分析结果显示,PTX3与WBC(r=0.300,P=0.046)、NE(r=0.422,P=0.004)、Scr(r=0.320,P=0.032)、hs-CRP(r=0.342,P=0.022)、内皮素(r=0.307,P=0.036)呈正相关,与RHI(r=-0.374,P=0.011)呈负相关。结论 CKD患者PTX3与内皮素呈正相关,与RHI呈负相关。与hs-CRP相比,PTX3对于预测CKD患者血管内皮功能障碍可能是一个更好的指标。
[Abstract]:Objective to investigate the relationship between pentagglutinin 3 (PTX 3) and vascular endothelial dysfunction in patients with chronic kidney disease (CKD) without dialysis. Methods from April 2012 to December 2013, 70 patients with CKD who were hospitalized or outpatient treated in Department of Renal Medicine, Beijing Chaoyang Hospital affiliated to Capital Medical University, were selected. A simplified MDRD formula was used to calculate and estimate glomerular filtration rate (GFR). According to e GFR, patients were divided into three groups: group A (group A) and group B (group B). The patients were divided into two groups: group A (group A) and group B (group B). Another 30 healthy subjects were selected as control group in Beijing Chaoyang Hospital affiliated to Capital Medical University in the same period. The serum PTX3 was detected by ELISA and the reactive hyperemia index (RHI) by peripheral arterial tension test. Collect general data of 3 groups [sex, age, incidence of diabetes, incidence of hypertension, smoking rate, Systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), mean arterial pressure (map), body mass index (BMI)], laboratory tests [WBC count, neutrophil fraction (neo), hemoglobin HGBN, Albumin, total cholesterol (TC), triacylglycerol (TGN), high density lipoprotein gallbladder (HDL-C). High density lipoprotein cholesterol, low density lipoprotein cholesterol, urea nitrogen bun, creatinine creatinine, creatinine, uric acid UAA, serum calcium, Serum phosphorus, total parathyroid hormone (PTH)], inflammatory index [hypersensitive C-reactive protein (hs-CRP) PTX3], vascular endothelial function index (endothelin), and the correlation between PTX3 and various indexes in CKD patients were analyzed. Results the map of group A was higher than that of group B (P 0.05). The map of group A was higher than that of group A (P 0.05). Group A was higher than control group (P 0.05). Group A was lower than control group (P 0.05). The level of blood phosphorus PTH was higher than that of group A (HGBs), and the level of serum calcium was lower than that of control group (P < 0.05) and group A (P < 0.05). The level of serum calcium in group A was lower than that in group A and the level of ALB in group A was lower. The results of correlation analysis showed that the PTX3 of group A was higher than that of group A (P 0.05). The PTX3 of group A was higher than that of group B (P 0.05), and the level of endothelin was higher than that of group A (P 0.05). Pearson correlation analysis showed that there was a positive correlation between PTX3 and WBCr0.300P0.04Scrrrn 0.320P0.032hCRPr0.342P0. 0222P, et 0.307P0. 036. the results of correlation analysis showed that there was a positive correlation between PTX3 and WBCr0. 300P0. 004P0. 004Scrrn 0.320P0. 320P0. 32hCRPr0. 342P0. 0222P, endothelin 0. 307P0. 036. the results showed that there was a positive correlation between PTX3 and WBCr0. 300P0. 004P0. 004. There was a negative correlation with RHI ru-0.374 (P < 0. 011). Conclusion PTX3 is positively correlated with endothelin and negatively correlated with RHI in CKD patients. Compared with hs-CRP, PTX3 may be a better marker for predicting vascular endothelial dysfunction in patients with CKD.
【作者单位】： 首都医科大学附属北京朝阳医院肾内科;北京积水潭医院肾内科;首都医科大学附属北京朝阳医院综合科;
【分类号】：R692
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本文编号：1856116