摘要
目的探讨维持性血液透析（NI／D）患者循环内皮细胞（CEC）与动脉粥样硬化（AS）的关系。方法选取MHD患者65例、慢性。肾脏病4-5期非透析患者（CKD-non-HD）25例和健康对照者24例为研究对象。抽取外周血，多参数流式细胞仪计数CEC数目。用CD3-PerCP和CD146-PE进行标记，确定CD3-CD146＋的细胞为CEC。检测颈总动脉内中膜厚度（CCA-IMT）及有关临床参数。对CEC与IMT及有关参数进行相关和回归分析。结果MHD组透前和CKD-non-HD组CEC数目[（151.52±98.24）和（183.00±81.38）个／ml]均显著高于健康对照组[（106.50±24.14）个／ml]（分别为P〈0.05和P〈0.01），但MHD组和CKD-non-HD组间差异无统计学意义。MHD组和CKD-non-HD组CCA-IMT[（0.94±0.36）和（1.02±0.37）mm]均显著高于健康对照组[（0.75±0.15）mm]（分别为P〈0.05和P〈0.01）。MHD组透前血CEC数目和CCA-IMT呈正相关（r=0.328，P〈0.01）。多元回归分析显示，MHD组CEC是颈动脉IMT的独立危险因素。结论CEC是MHD患者AS的独立危险因素，可作为评价MHD患者血管内皮损伤程度的新指标。
Objective To explore the association between circulating endothelial cells （CECs） and atherosclerosis in maintenance hemodialysis （MHD） patients. Methods A cross-sectional study was performed to investigate the association between CECs and carotid atherosclerotic change in 65 MHD patients,25 non-hemodialysis patients with chronic kidney disease （CKD） of stage 4 or 5 （CKD-non-HD） and 24 age-and sex-matched healthy controls. CECs in peripberal blood were determined by muhiparametric flow eytometry （FCM）. CECs were labeled with CD3-PerCP and CD146-PE before FCM and identified as CD3dim/CD146bright. Atherosclerosis in both groups was assessed by the measurement of common carotid artery intimamedia thickness （CCA-IMT） and plaque of the common carotid arteries with ultrasound scanner. Results CECs were significantly higher in pre-dialysis patients[（151.52±98.24） cell/ml] and CKD-non-HD patients [（183.00±81.38） cell/ml] compared with control group[（106.50±24.14） cell/ml] （P〈0.05 and P〈0.01, respectively）. But the number of CECs was not significantly different between MHD and CKD-non-HD patients. CCA-IMT was also significantly higher in MHD patients [（0.94±0.36） mini and CKD-non-HD patients[（1.02±0.37）mm] compared with control group [（0.75±0.15）mm] （P〈0.05 and P〈0.01, respectively）. The number of pre-dialysis CECs was positively correlated with CCA-IMT in MHD patients （r=0.328, P〈0.01）. Multivariate analysis showed that CEC level was a strong independent risk factor of CCA-IMT. Conclusion In MHD patients, CEC level is associated with carotid atherosclerosis and may be used as a marker to evaluate the endothelial damage.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2009年第12期916-920,共5页
Chinese Journal of Nephrology
