维持性血液透析患者血浆apelin水平与颈动脉粥样硬化的关系

发布时间：2018-06-15 06:31

本文选题：apelin + 血液透析　；参考：《中南大学学报(医学版)》2017年06期

【摘要】：目的:探讨维持性血液透析(maintenance hemodialysis,MHD)患者血浆脂肪细胞因子apelin的水平及其与颈动脉粥样硬化的关系。方法:以92例MHD患者为研究对象,36例年龄和性别相匹配者作为健康对照组。采用放射免疫测定法检测血浆apelin水平;ELISA法检测血清内皮细胞损伤标志物血栓调节蛋白(thrombomodulin)、血管性血友病因子(von Willebrand factor,vWF)、CD146水平和炎症因子超敏C反应蛋白(hsCRP)、IL-6和TNF-α水平;高分辨超声技术测定颈总动脉内膜-中层厚度(common carotid artery intima and media thickness,CCA-IMT),切面内膜中层面积(crosssectional calculated intima-media area,cIM area)及粥样硬化斑块。结果:MHD组患者血浆apelin水平明显低于健康对照组(P0.01),伴随血清thrombomodulin,vWF,CD146,hsCRP,IL-6和TNF-α明显升高(均P0.01)。颈动脉有斑块的MHD患者血浆apelin低于无斑块者[(43.16±10.12)pg/mL vs(61.43±16.25)pg/mL,P0.01]。MHD组患者血浆apelin浓度与CCA-IMT,cIM area呈负相关(r分别为 0.355和 0.297,均P0.01)。多元逐步回归分析结果显示血浆apelin是CCA-IMT和cIM area的独立危险因素。结论:MHD患者血浆apelin水平明显降低,其可能通过促进hsCRP,IL-6,TNF-α等炎症因子的产生,参与血管内皮损伤和动脉粥样硬化的进展,并在尿毒症相关动脉粥样硬化的启动与发展中起一定作用。
[Abstract]:Objective: to investigate the level of plasma adipocyte factor (apelin) and its relationship with carotid atherosclerosis in maintenance hemodialysis patients with maintenance hemodialysis (HD). Methods: a total of 92 MHD patients were studied. 36 patients with age and sex matched as healthy control group. Plasma levels of apelin were measured by radioimmunoassay. The levels of thrombomodulinine, von Willebrand factor and von Willebrand factor vWFU CD146, IL-6 and TNF- 伪 were detected by Elisa. The intima-media thickness of common carotid artery was measured by high resolution ultrasound. The common carotid artery intima and media thicknessnessnessna CCA-IMT, cross sectional calculated intima-media area cIM area) and atherosclerotic plaques were measured. Results the plasma apelin level in the patients with MHD was significantly lower than that in the healthy control group (P 0.01), and the levels of IL-6 and TNF- 伪 in the serum thrombomodulinine (WFU) CD146 hsCRPU and TNF- 伪 were significantly higher than those in the control group (all P 0.01). The plasma apelin in patients with carotid artery plaque was significantly lower than that in patients without plaque [43.16 卤10.12 g / mL vs(61.43 卤16.25 渭 g / mL P0.01] .There was a negative correlation between plasma apelin concentration and CCA-IMTX CIM area in MHD group (P < 0.01). Multiple stepwise regression analysis showed that plasma apelin was an independent risk factor for CCA-IMT and CIM area. Conclusion the level of plasma apelin in patients with MHD is significantly decreased, which may play a role in the initiation and development of uremia related atherosclerosis by promoting the production of inflammatory factors such as hsCRP, IL-6, TNF- 伪, and participating in the progress of vascular endothelial injury and atherosclerosis.
【作者单位】：中南大学湘雅医院肾内科;
【基金】：国家自然科学基金(81500559)~~
【分类号】：R459.5;R543

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