摘要
目的:探讨维持性血液透析患者(MHD)外周血单个核细胞NF-κB水平与心血管疾病(CVD)及全因死亡、心血管疾病(CVD)死亡的关系,评估NF-κB对MHD患者预后的影响。方法:选取2012年1月在我院接收MHD治疗且大于6个月的终末期肾衰竭患者(160例)作为研究对象,采用ELISA法检测NF-κB水平。所有患者随访5年,记录新发的非致死性CVD和患者的死亡原因和时间。根据NF-κB四分位数,将患者分为四组,A组(NF-κB<750.82 ng·mg^-1核蛋白)、B组(750.82 ng·mg^-1核蛋白≤NF-κB<1142.42 ng·mg^-1核蛋白)、C组(1142.42 ng·mg^-1核蛋白≤NF-κB<1612.91 ng·mg^-1核蛋白)、D组(NF-κB≥1612.9 ng·mg^-1核蛋白)。采用Kaplan-Meier生存曲线分析四组的全因死亡和CVD死亡的生存率。结果:四组间hsCRP、NT-proBNP以及糖尿病患病率具有差异有统计学意义,其中NF-κB水平最高的D组hsCRP和NT-proBNP明显高于A组、B组和C组(P均<0.05)。随访5年共有110例患者新发各类非致死性CVD,四组冠状动脉疾病、脑血管意外以及外周动脉闭塞发生率具有差异有统计学意义(P均<0.05),其中D组患者上述三种新发非致死CVD发生率均明显高于A组(P均<0.008);四组患者CVD病死率和全因死亡率具有差异有统计学意义(P均<0.05),D组生存率低于A组和B组(P均<0.05)。结论:外周血单个核细胞NF-κB水平和MHD患者CVD密切相关,NF-κB水平升高可增加CVD的发生率,且患者预后较差。
Objective:To investigate the relationships of NF-κB in cardiovascular disease(CVD)patients with maintenance hemodialysis(MHD),and to evaluate the effect of NF-kappa B on the prognosis of MHD patients.Methods:A total of 160 patients with end-stage renal failure receiving MHD treatment in our hospital in January2012 and more than 6 months were selected as the subjects,and the NF-κB level was detected by ELISA.All patients were followed up for 5 years to record the new non-fatal CVD and the cause and time of death.According to NF-κB,the patients were divided into four groups,group A(NF-κB<750.82 ng·mg^-1),group B(750.82 ng·mg^-1≤NF-κB<1142.42 ng·mg^-1),group C(1142.42 ng·mg^-1≤NF-κB<1612.91 ng·mg^-1 nucleoprotein),group D(NF-κB<1612.9 ng·mg^-1).Kaplan-meier survival curve was used to analyze the survival rate of all four groups due to death and CVD death.Results:There were significant differences in hsCRP,NT-proBNP and diabetes prevalence among the four groups,and hs-CRP and NT-proBNPin group D were significantly higher than those in group A,group B and group C(P<0.05).There were significant differences in the incidence of coronary artery diseases,cerebrovascular accidents and peripheral artery occlusion in all kinds of nonfatal CVD,patients followed up for 5 years.The incidence of non-lethal CVD in group D was significantly higher than that in group A(P<0.008).There were significant differences in CVD mortality and all-cause mortality among the four groups(P<0.05).The survival rate of D group was lower than that of group A and B(P<0.05).Conclusion:The level of NF-κB in peripheral blood mononuclear cells is closely related to CVD in patients with MHD.The increase of NF-κB level can increase the incidence of CVD,and the prognosis of the patients is poor.
作者
张羽
廖畅
吕鑫
王晓旭
焦军东
ZHANG Yu;LIAO Chang;LU Xin;WANG Xiaoxu;JIAO Jundong(Department of 3th Nephrology,the Second Affiliated Hospital of Harbin Medical University,Harbin 150000,China;Department of Infectious Immunology,Harbin City First Hospital,Harbin 150000,China;Department of Nephrology,the Second Affiliated Hospital of Harbin Medical University,Harbin 150000,China)
出处
《现代医学》
2019年第8期951-955,共5页
Modern Medical Journal
