摘要
目的探讨维持性血液透析(MHD)患者C反应蛋白(CRP)、同型半胱氨酸(Hcy)与动脉粥样硬化(AS)的关系。方法测定82例MHD患者透析前的血浆总Hcy(tHcy)、CRP、血清肌酐(SCr)、尿素氮(BUN)、总胆固醇(TC)及白蛋白(Alb)和80例健康对照者的tHcy、CRP;应用Sequoia512超声仪测定颈动脉内膜中层厚度(IMT)及粥样硬化斑块。结果①MHD组IMT平均值、IMT增厚阳性率、斑块阳性检出率、血清CRP以及血浆tHcy水平均显著高于正常对照组(P<0.001),体重指数(BMI)显著低于正常对照组(P<0.01);②MHD伴动脉硬化者的年龄、CRP显著高于非动脉硬化组(P<0.05),动脉硬化组的tHcy、BMI和Alb显著低于非动脉硬化组(P<0.05),而血浆TC、BUN、舒张压等指标两亚组之间差异无显著性(P>0.05);③多因素逐步回归分析显示,影响颈动脉IMT的因素有年龄、CRP、血浆tHcy水平(P<0.05);④直线相关分析表明,血浆tHcy水平与Alb显著正相关(r=0.528,P=0.000)。结论MHD患者血浆tHcy及血清CRP均明显高于健康人,MHD患者AS的发生与高水平血清CRP、相对低水平的血浆tHcy(但仍高于正常对照)及Alb等密切相关,评价tHcy在MHD患者AS中的作用时可能综合考虑到炎症、低蛋白血症和营养不良等因素的相互作用。
Objective To evaluate the correlation between C-reactive protein （CRP） ,homocysteine （Hcy）and atherosclerosis （AS） in the maintenance hemodialysis patients （ MHD）. Methods 82 MHD patients and 80 healthy volunteers were involved in this study. The levels of plasma total homocysteine （tHcy） ,CRP,serum creatine（Scr） ,blood urea nitrogen （BUN） ,total cholesterol（TC） ,and albumin （Alb） were determined in 82 MHD cases, tHcy and CRP were determined in 80 healthy controls. Intima-medial thickness （IMT） of carotid arteries and the presence of atherosclerotic plaques were determined by Sequoia 512 ultrasonography. Results ①The average IMT,positive rate of increased IMT and presence of atherosclerotic plaque in carotid artery and the levels of plasma tHcy and serum CRP in MHD patients were significantly higher than those in healthy control （ P 〈 0. 001 ） , and the body mass index （BMI） was significantly lower than that in healthy control（ P 〈 0.01 ）. ②The patients＇ages and serum CRP in MHD patients with atherosclerosis were significantly higher than those in MHD patients without atherosclerosis（P 〈0.05） ,and the levels of plasma tHcy,plasma Alb and BMI were significantly lower in MHD patients with atherosclerosis than those in MHD patients without atherosclerosis （ P 〈 0.05 ）. Meanwhile, there were no significant differences of plasma TC, BUN and diastolic blood pressure （DBP） between the patients with and without MHD （ P 〉0.05 ）. ③Multiple stepwise regression analysis showed that in MHD patients,the risk factors associated with value of IMT were age, serum CRP and plasma tHcy（ P 〈 0.05 ）. ④Linear correlation analysis showed that the levels of plasma tHcy was positively correlated with the levels of plasma Alb （ r = 0. 528, P = 0. 000 ）. Conclusions The levels of plasma tHcy and serum CRP are significantly higher in MHD patients than those in normal control. Higher levels of serum CRP and relatively low levels of plasma tHcy �
出处
《中国综合临床》
北大核心
2005年第9期795-798,共4页
Clinical Medicine of China
