血液透析患者血清Hcy、NO、ADMA相关性研究
发布时间：2018-08-20 11:58
【摘要】：目的： 探讨维持性血液透析患者血清尿素氮（UREA）、血清肌酐（CREA）、血清Hcy、血清NO、血清ADMA五项指标的变化，评价血液透析对尿毒症患者血清Hcy、血清NO、血清ADMA的影响以及他们之间的相关性。 方法： 1研究对象 1.1对照组：我院健康查体者22例，其中男性13例，女性9例，年龄25-73岁，平均年龄47.95±16.27。 1.2尿毒症期非透析组：患者22例，为2011年3月-2012年3月在河北医科大学第二医院血液透析科住院治疗的患者，其中男性12例，女性10例，年龄23-76岁，平均年龄45.54±15.51岁。 1.3慢性肾功能不全尿毒症期维持性血液透析组：共22例。均在河北医科大学第二医院血液透析科诊断为尿毒症并建立血管通路后行血液透析治疗。透析时间3个月。其中男性11例，女性11例，年龄22-78岁,平均年龄48.77±18.45岁。 2观察指标：患者的姓名、性别、年龄、身高、体重、病程、血液透析时间、超滤量、血压、心率、原发病、尿量、血清尿素氮(UREA)、血清肌酐(CREA)、血清Hcy、NO、ADMA等。 结果： 1三组间年龄、性别一般情况分析：三组间年龄、性别构成无差异。 2三组间肾功能分析：对照组血清UREA水平为5.19±0.95mmol/L，血清CREA水平为83.95±12.74μmol/L，血清β2MG水平为1.34±0.62μmol/L；尿毒症组血清UREA水平为24.85±6.23mmol/L，血清CREA水平为798.59±214.56μmol/L，血清β2MG水平为14.54±4.12μmol/L；血液透析组透析前血清UREA水平为28.57±7.67mmol/L，血清CREA水平为898.50±243.90μmol/L，血清β2MG水平为16.58±3.60μmol/L；血液透析组透析后血清UREA水平为10.46±4.06mmol/L，血清CREA水平为405.39±142.07μmol/L，血清β2MG水平为15.70±2.23μmol/L。进行统计学分析后，尿毒症组、血液透析组透析前、血液透析组透析后血清UREA、CREA、β2MG均高于对照组（P0.01）；血液透析组透析前血清UREA（P0.05）、CREA（P0.01）、β2MG（P0.05）均高于尿毒症组；血液透析组透析后血清UREA、CREA均低于透析前（P0.01）。 3三组间血清Hcy、血清NO和血清ADMA水平的比较:对照组血清Hcy水平为8.21±1.55μmol/L，血清NO水平为45.97±13.36μmol/L，血清AMDA水平为0.34±0.14μmol/L；尿毒症组血清Hcy水平为45.57±14.40μmol/L，血清NO水平为151.37±54.70μmol/L，血清AMDA水平为0.89±0.18μmol/L；血液透析组透析前血清Hcy水平为30.80±2.36μmol/L，血清NO水平为144.12±76.72μmol/L，血清AMDA水平为0.89±0.24μmol/L；血液透析组透析后血清Hcy水平为19.31±1.63μmol/L，血清NO水平为59.97±27.61μmol/L，血清AMDA水平为0.60±0.39μmol/L。进行统计学分析后，尿毒症组、血液透析组透析前、血液透析组透析后血清Hcy、NO、ADMA均高于对照组（P0.01）；血液透析组透析前血清Hcy、ADMA低于尿毒症组（P0.05）；血液透析组透析前血清NO低于尿毒症组（P0.05）；血液透析组透析后血清Hcy、NO、ADMA均低于透析前（P0.01）。 4血清Hcy与年龄、血清NO、血清ADMA在对照组、尿毒症组、血液透析组的相关性分析：对照组血清Hcy与年龄（r=-0.06，P0.05）、血清NO（r=-0.33，P0.05）无相关性，与血清ADMA成正相关关系（r=0.62，P0.01）；尿毒症组血清Hcy与年龄（r=0.23，P0.05）、血清NO（r=0.18，P0.05）无相关性，与血清ADMA成正相关关系（r=0.79，，P0.01）。血液透析组血清Hcy与年龄（r=-0.13，P0.05）、血清NO（r=-0.10，P0.05）无相关性，与血清ADMA成正相关关系（r=0.50，P0.05）。 5尿毒症组病人血清NO和血清肌酐、血清尿素氮相关性分析：尿毒症组血清NO和血清肌酐相关（r=0.82，P0.01），尿毒症组血清NO和血清尿素氮相关（r=0.89，P0.01）。 结论： 1尿毒症患者血清Hcy、血清ADMA比正常人群升高，是CVD并发症的重要危险因素。 2血液透析可部分清除血清Hcy、ADMA，来改善血管内皮功能，有利于CKD患者CVD并发症的防治。 3ESRD患者血清Hcy和血清ADMA相关。 4尿毒症患者血清NO比正常人群升高，可能与内皮功能紊乱、炎症等因素有关。
[Abstract]:Objective:
Objective To investigate the changes of serum urea nitrogen (UREA), serum creatinine (CREA), serum Hcy, serum NO and serum ADMA in maintenance hemodialysis patients, and to evaluate the effects of hemodialysis on serum Hcy, serum NO and serum ADMA in uremia patients and their correlation.
Method:
1 object of study
1.1 Control group: There were 22 cases of physical examination in our hospital, including 13 males and 9 females, aged 25-73 years, with an average age of 47.95+16.27.
1.2 Non-dialysis group in uremic stage: 22 patients were hospitalized in the Department of Hemodialysis of the Second Hospital of Hebei Medical University from March 2011 to March 2012. There were 12 males and 10 females, aged 23-76 years, with an average age of 45.54 (+ 15.51).
1.3 Maintenance hemodialysis group of 22 patients with chronic renal insufficiency in uremia stage were treated with hemodialysis after diagnosis of uremia and establishment of vascular access in the Department of Hemodialysis of the Second Hospital of Hebei Medical University.
2 Observation Indicators: Name, sex, age, height, weight, duration of disease, hemodialysis time, ultrafiltration volume, blood pressure, heart rate, primary disease, urine volume, serum urea nitrogen (UREA), serum creatinine (CREA), serum Hcy, NO, ADMA, etc.
Result:
1 there was no difference in age and sex between the three groups: there was no difference in age and sex between the three groups.
Renal function analysis among the three groups: serum UREA level in control group was 5.19 (+ 0.95) mmol/L, serum CREA level was 83.95 (+ 12.74) mmol/L, serum beta-2MG level was 1.34 (+ 0.62) mmol/L, serum UREA level was 24.85 (+ 6.23) mmol/L, serum CREA level was 798.59 (+ 214.56) mmol/L, serum beta-2MG level was 14.54 (+ 4.12) mmol/L in hemodialysis group. Before hemodialysis, serum UREA level was 28.57 [7.67] mmol/L, serum CREA level was 898.50 [243.90] micromol/L, serum beta-2MG level was 16.58 [3.60] micromol/L; after hemodialysis, serum UREA level was 10.46 [4.06] mmol/L, serum CREA level was 405.39 [142.07] micromol/L, serum beta-2MG level was 15.70 [2.23] micromol/L. Before hemodialysis, serum UREA, CREA, and beta 2MG in hemodialysis group were higher than those in control group (P 0.01); before hemodialysis, serum UREA (P 0.05), CREA (P 0.01), and beta 2MG (P 0.05) in hemodialysis group were higher than those in uremia group; after hemodialysis, serum UREA and CREA were lower than those before hemodialysis (P 0.01).
Comparison of serum Hcy, NO and ADMA levels among the three groups: serum Hcy, NO and AMDA levels in the control group were 8.21 The levels of serum Hcy, NO, AMDA, and Hcy were 30.80 (+ 2.36) and 0.89 (+ 0.24) and 59.97 (+ 27.61) and 0.60 (+ 0.39) respectively before and after hemodialysis. After dialysis, the levels of Hcy, NO and ADMA in hemodialysis group were higher than those in control group (P 0.01), Hcy and ADMA in pre-dialysis group were lower than those in uremia group (P 0.05), NO in pre-dialysis group was lower than that in uremia group (P 0.05), and Hcy, NO and ADMA in post-dialysis group were lower than those in pre-dialysis group (P 0.05). (P0.01).
Serum Hcy and age, serum NO, serum ADMA in the control group, uremia group, hemodialysis group correlation analysis: control group serum Hcy and age (r = - 0.06, P 0.05), serum NO (r = - 0.33, P 0.05) no correlation, and serum ADMA was positively correlated (r = 0.62, P 0.01); uremia group serum Hcy and age (r = 0.23, P 0.05), serum NO (r = 0.18, P 0.05) no correlation. There was no correlation between serum Hcy and age (r = - 0.13, P 0.05), serum NO (r = - 0.10, P 0.05), but positive correlation with serum ADMA (r = 0.50, P 0.05).
5 Correlation analysis of serum NO and serum creatinine, serum urea nitrogen in uremia group: serum NO and serum creatinine in uremia group were correlated (r=0.82, P 0.01), serum NO and serum urea nitrogen in uremia group were correlated (r=0.89, P 0.01).
Conclusion:
1 serum Hcy and serum ADMA in uremic patients were higher than those in the normal population, which is an important risk factor for CVD complications.
Hemodialysis can partly remove serum Hcy and ADMA to improve vascular endothelial function, which is conducive to the prevention and treatment of CVD complications in patients with CKD.
Serum Hcy was correlated with serum ADMA in 3ESRD patients.
4 the serum NO of uremic patients is higher than that of the normal population, which may be related to endothelial dysfunction, inflammation and other factors.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692.5
本文编号：2193524
[Abstract]:Objective:
Objective To investigate the changes of serum urea nitrogen (UREA), serum creatinine (CREA), serum Hcy, serum NO and serum ADMA in maintenance hemodialysis patients, and to evaluate the effects of hemodialysis on serum Hcy, serum NO and serum ADMA in uremia patients and their correlation.
Method:
1 object of study
1.1 Control group: There were 22 cases of physical examination in our hospital, including 13 males and 9 females, aged 25-73 years, with an average age of 47.95+16.27.
1.2 Non-dialysis group in uremic stage: 22 patients were hospitalized in the Department of Hemodialysis of the Second Hospital of Hebei Medical University from March 2011 to March 2012. There were 12 males and 10 females, aged 23-76 years, with an average age of 45.54 (+ 15.51).
1.3 Maintenance hemodialysis group of 22 patients with chronic renal insufficiency in uremia stage were treated with hemodialysis after diagnosis of uremia and establishment of vascular access in the Department of Hemodialysis of the Second Hospital of Hebei Medical University.
2 Observation Indicators: Name, sex, age, height, weight, duration of disease, hemodialysis time, ultrafiltration volume, blood pressure, heart rate, primary disease, urine volume, serum urea nitrogen (UREA), serum creatinine (CREA), serum Hcy, NO, ADMA, etc.
Result:
1 there was no difference in age and sex between the three groups: there was no difference in age and sex between the three groups.
Renal function analysis among the three groups: serum UREA level in control group was 5.19 (+ 0.95) mmol/L, serum CREA level was 83.95 (+ 12.74) mmol/L, serum beta-2MG level was 1.34 (+ 0.62) mmol/L, serum UREA level was 24.85 (+ 6.23) mmol/L, serum CREA level was 798.59 (+ 214.56) mmol/L, serum beta-2MG level was 14.54 (+ 4.12) mmol/L in hemodialysis group. Before hemodialysis, serum UREA level was 28.57 [7.67] mmol/L, serum CREA level was 898.50 [243.90] micromol/L, serum beta-2MG level was 16.58 [3.60] micromol/L; after hemodialysis, serum UREA level was 10.46 [4.06] mmol/L, serum CREA level was 405.39 [142.07] micromol/L, serum beta-2MG level was 15.70 [2.23] micromol/L. Before hemodialysis, serum UREA, CREA, and beta 2MG in hemodialysis group were higher than those in control group (P 0.01); before hemodialysis, serum UREA (P 0.05), CREA (P 0.01), and beta 2MG (P 0.05) in hemodialysis group were higher than those in uremia group; after hemodialysis, serum UREA and CREA were lower than those before hemodialysis (P 0.01).
Comparison of serum Hcy, NO and ADMA levels among the three groups: serum Hcy, NO and AMDA levels in the control group were 8.21 The levels of serum Hcy, NO, AMDA, and Hcy were 30.80 (+ 2.36) and 0.89 (+ 0.24) and 59.97 (+ 27.61) and 0.60 (+ 0.39) respectively before and after hemodialysis. After dialysis, the levels of Hcy, NO and ADMA in hemodialysis group were higher than those in control group (P 0.01), Hcy and ADMA in pre-dialysis group were lower than those in uremia group (P 0.05), NO in pre-dialysis group was lower than that in uremia group (P 0.05), and Hcy, NO and ADMA in post-dialysis group were lower than those in pre-dialysis group (P 0.05). (P0.01).
Serum Hcy and age, serum NO, serum ADMA in the control group, uremia group, hemodialysis group correlation analysis: control group serum Hcy and age (r = - 0.06, P 0.05), serum NO (r = - 0.33, P 0.05) no correlation, and serum ADMA was positively correlated (r = 0.62, P 0.01); uremia group serum Hcy and age (r = 0.23, P 0.05), serum NO (r = 0.18, P 0.05) no correlation. There was no correlation between serum Hcy and age (r = - 0.13, P 0.05), serum NO (r = - 0.10, P 0.05), but positive correlation with serum ADMA (r = 0.50, P 0.05).
5 Correlation analysis of serum NO and serum creatinine, serum urea nitrogen in uremia group: serum NO and serum creatinine in uremia group were correlated (r=0.82, P 0.01), serum NO and serum urea nitrogen in uremia group were correlated (r=0.89, P 0.01).
Conclusion:
1 serum Hcy and serum ADMA in uremic patients were higher than those in the normal population, which is an important risk factor for CVD complications.
Hemodialysis can partly remove serum Hcy and ADMA to improve vascular endothelial function, which is conducive to the prevention and treatment of CVD complications in patients with CKD.
Serum Hcy was correlated with serum ADMA in 3ESRD patients.
4 the serum NO of uremic patients is higher than that of the normal population, which may be related to endothelial dysfunction, inflammation and other factors.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692.5
【引证文献】
相关期刊论文 前1条
1 邹丽娥;钟郑新;王春凤;廖伟群;;高通量透析对尿毒症维持性血液透析患者血清HCY、β_2-MG、CysC的影响[J];中国当代医药;2016年12期
本文编号：2193524
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