中老年维持性血液透析患者动脉僵硬度与炎症细胞因子及氧化应激的关系

肾脏病与透析肾移植杂志 ›› 2012, Vol. 21 ›› Issue (6): 536-539.

中老年维持性血液透析患者动脉僵硬度与炎症细胞因子及氧化应激的关系

出版日期:2012-12-28 发布日期:2012-12-31

Carotid atherosclerosis and inflammation and oxidative stress in eldly patients with hemodialysis

Online:2012-12-28 Published:2012-12-31

摘要/Abstract

摘要：

摘要目的：探讨维持性血液透析（MHD）患者体内微炎症状态、氧化应激与血液透析患者颈总动脉僵硬度(CAS)间关系。方法：采用超声技术测定测量颈总动脉硬化参数β作为评价大动脉僵硬度指标,根据有无颈总动脉僵硬将MHD患者分为CAS组和非CAS组。常规检测两组患者白蛋白（Alb）、血钙、血磷、总胆固醇（TC）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、三酰甘油（TG）、血糖、血清肌酐（SCr）等、C反应蛋白等血清学指标。采用ELISA法检测两组患者血清肿瘤坏死因子α(TNF-α),白细胞介素6(IL-6)，8异前列腺素（8-isoprostane） F2α浓度水平。结果：（1）CAS组患者42例，其中男性31例，女性11例，平均年龄57.2±7.8岁（45～73岁），透析龄3 ～ 61月（中位数34月）；非CAS组患者20例，其中男性12例，女性8例，年龄47～76，平均年龄（56.2±8.7岁），透析龄3 ～ 56月（中位数32月）；（2）两组患者在年龄、透析龄、舒张压、BUN、Cr、TC、TG、MHDL、LDL、血红蛋白（Hb）方面无明显差异。CAS组收缩压高于非CAS组；（3）CAS组8-isoprostane水平高于非CAS组,分别为68.77±45.96 pg/ml 和25.56± 27.48 pg/ml（P<0.01）。两组患者血清高敏C反应蛋白（hs-CRP）、TNF-α、IL-6水平均高于正常水平，但统计学分析发现两组间血清hs-CRP、TNF-α、IL-6水平却无明显统计学上差异。结论：本研究表明MHD患者体内普遍存在微炎症状态，但在动脉硬化形成过程中，炎症因子可能参与其中，但高血压和氧化应激所起作用可能更为重要。

关键词: 【关键词】血液透析动脉僵硬度炎症细胞因子 , 8异前列腺素

Abstract:

ABSTRACT Objective：To identify the relationship of arterial stiffness with oxidative stress and micro infalammation state in the middle-age and eldly hemodialysis patients. Methodology: Sixty two cases with maintenance hemodialysis (MHD) were enrolled in this study. Based on the presence or absence of carotid arterial stiffness (CAS), they were divided into MHD+CAS group (n=42) and simply MHD group (n=20). The carotid atherosclerosis parameters β obtained by ultrasound technology was used to assess arterial stiffness. The parameters of albumin (ALB), calcium (Ca), serum phosphorus (P), total cholesterol (TC), high density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG serological markers ), glucose, creatinine, and C-reactive protein were routinely tested in both of the two groups. The levels of TNF-α, IL-6 and 8-isoprostane F2α were measured by ELISA. Results: （1）In MHD + the CAS group, they were 31 males and 11 females with an age of 45 - 73 years old (57.2 ± 7.80) , and the dialysis duration of 3 - 61 months ( median 34 months). In the MHD group, they were 12 males and 8 females with an age of 47 -76 years old (56.2 ± 8.7), and the dialysis duration of 3-56 months ( median 32 months ).（2）The respect of age, dialysis duration, the levels of DBP , BUN , Cr , TC , TG , HDL , LDL, and Hb have no significant difference between the MHD+CAS group and MHD group. The level of SBP in the MHD +CAS group was higher than that in the MHD group. （3）The level of 8-isoprostane in the MHD+CAS group was higher than that in the MHD group (68.8 ± 45.9 vs 25.6 ± 27.5 pg/ml, P <0.01) respectively. The levels of hs-CRP、TNF-α、and IL-6 in both groups was higher than that of the normal levels, but they have no statistical difference. Conclusion: We demonstrate that there is a micro inflammation state in MHD patients. The inflammatory factor may lead to atherosclerosis, but hypertension and oxidative stress may be more important.

Key words: Key words: hemodialysis arterial stiffness inflammatory cytokines 8-isoprostane F2&alpha

任红旗，周璇，栾智勇，等. 中老年维持性血液透析患者动脉僵硬度与炎症细胞因子及氧化应激的关系[J]. 肾脏病与透析肾移植杂志, 2012, 21(6): 536-539.

REN Hong-qi, ZHOU Xuan, LUAN Zhi-yong, et al. Carotid atherosclerosis and inflammation and oxidative stress in eldly patients with hemodialysis[J]. Chinese Journal of Nephrology, Dialysis & Transplantation, 2012, 21(6): 536-539.

ISSN 1006-298X CN 32-1425/R