中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2011年
8期
581-584
,共4页
李忠心%陈向东%孟娟%张新%彭立人
李忠心%陳嚮東%孟娟%張新%彭立人
리충심%진향동%맹연%장신%팽립인
肾疾病,慢性%动脉硬化%血栓调节蛋白
腎疾病,慢性%動脈硬化%血栓調節蛋白
신질병,만성%동맥경화%혈전조절단백
Kidney diseases,chronic%Arteriosclerosis%Thrombomodulin
目的 探讨慢性肾脏病(CKD)患者血栓调节蛋白(Tm)水平与动脉粥样硬化(AS)的相关性。方法 以北京朝阳医院肾内科住院的96例CKD患者为对象，其中血液透析32例，非透析64例；30例健康志愿者为对照。参试者均于清晨空腹采静脉血，分别测定Scr、胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白、C反应蛋白、血红蛋白及血栓调节蛋白。应用彩色多普勒超声检测颈动脉内膜中层厚度(IMT)。对血栓调节蛋白与IMT及相关参数进行相关分析。结果 CKD患者血栓调节蛋白为(12.15±3.04) mg/L，显著高于健康对照组的(3.12±0.23) mg/L(P＜0.01)。血液透析组血栓调节蛋白为(16.89±3.35) mg/L，显著高于非透析组的(9.78±2.49) mg/L(P＜ 0.01)。血液透析组IMT值为(1.13±0.31) mm，斑块检出率为48.5％，均显著高于非透析治疗组的(0.95±0.33) mm和28.7％(均P＜0.05)。96例CRF患者的Tm水平与IMT呈正相关(r=0.335，P＜0.01)。动脉病变程度越重者，血浆Tm水平越高。多元逐步回归分析结果显示，Tm(OR=1.13，95％CI 1.010～1.121)、SBP(OR=1.09，95％CI1.009～1.114)、CRP(OR=1.22，95％CI 1.216～2.007)分别与CKD患者IMT独立相关。结论CKD患者Tm水平与IMT独立相关。血管内皮细胞损伤与CKD患者动脉粥样硬化并发症密切相关。Tm有可能成为血管内皮细胞损伤或功能紊乱的标志物。
目的 探討慢性腎髒病(CKD)患者血栓調節蛋白(Tm)水平與動脈粥樣硬化(AS)的相關性。方法 以北京朝暘醫院腎內科住院的96例CKD患者為對象，其中血液透析32例，非透析64例；30例健康誌願者為對照。參試者均于清晨空腹採靜脈血，分彆測定Scr、膽固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白、C反應蛋白、血紅蛋白及血栓調節蛋白。應用綵色多普勒超聲檢測頸動脈內膜中層厚度(IMT)。對血栓調節蛋白與IMT及相關參數進行相關分析。結果 CKD患者血栓調節蛋白為(12.15±3.04) mg/L，顯著高于健康對照組的(3.12±0.23) mg/L(P＜0.01)。血液透析組血栓調節蛋白為(16.89±3.35) mg/L，顯著高于非透析組的(9.78±2.49) mg/L(P＜ 0.01)。血液透析組IMT值為(1.13±0.31) mm，斑塊檢齣率為48.5％，均顯著高于非透析治療組的(0.95±0.33) mm和28.7％(均P＜0.05)。96例CRF患者的Tm水平與IMT呈正相關(r=0.335，P＜0.01)。動脈病變程度越重者，血漿Tm水平越高。多元逐步迴歸分析結果顯示，Tm(OR=1.13，95％CI 1.010～1.121)、SBP(OR=1.09，95％CI1.009～1.114)、CRP(OR=1.22，95％CI 1.216～2.007)分彆與CKD患者IMT獨立相關。結論CKD患者Tm水平與IMT獨立相關。血管內皮細胞損傷與CKD患者動脈粥樣硬化併髮癥密切相關。Tm有可能成為血管內皮細胞損傷或功能紊亂的標誌物。
목적 탐토만성신장병(CKD)환자혈전조절단백(Tm)수평여동맥죽양경화(AS)적상관성。방법 이북경조양의원신내과주원적96례CKD환자위대상，기중혈액투석32례，비투석64례；30례건강지원자위대조。삼시자균우청신공복채정맥혈，분별측정Scr、담고순、삼선감유、고밀도지단백、저밀도지단백、C반응단백、혈홍단백급혈전조절단백。응용채색다보륵초성검측경동맥내막중층후도(IMT)。대혈전조절단백여IMT급상관삼수진행상관분석。결과 CKD환자혈전조절단백위(12.15±3.04) mg/L，현저고우건강대조조적(3.12±0.23) mg/L(P＜0.01)。혈액투석조혈전조절단백위(16.89±3.35) mg/L，현저고우비투석조적(9.78±2.49) mg/L(P＜ 0.01)。혈액투석조IMT치위(1.13±0.31) mm，반괴검출솔위48.5％，균현저고우비투석치료조적(0.95±0.33) mm화28.7％(균P＜0.05)。96례CRF환자적Tm수평여IMT정정상관(r=0.335，P＜0.01)。동맥병변정도월중자，혈장Tm수평월고。다원축보회귀분석결과현시，Tm(OR=1.13，95％CI 1.010～1.121)、SBP(OR=1.09，95％CI1.009～1.114)、CRP(OR=1.22，95％CI 1.216～2.007)분별여CKD환자IMT독립상관。결론CKD환자Tm수평여IMT독립상관。혈관내피세포손상여CKD환자동맥죽양경화병발증밀절상관。Tm유가능성위혈관내피세포손상혹공능문란적표지물。
Objective To determine the correlation between thrombomodulin and atherosclerosis in chronic kidney diseases (CKD) patients. Methods A total of 96 CKD patients in our hospital were enrolled in the study, including 32 maintenance hemodialysis (MHD) patients and 64 non-hemodialysis CKD patients with stage 2 to 5 (non-HD) and 30 age- and gendermatched healthy volunteers were used as control.Intima-media thickness (IMT) and atherosclerotic plaques of the extracranial common carotid artery were detected by high-resolution B-mode ultrasonography. Blood level of thrombomodulin was measured using ELISA, and creatinine,triglycerides, cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol were measured routinely as well.Correlation analysis of thrombomodulin with other parameters was performed. Results The thrombomodulin level was significantly higher in CKD patients as compared to healthy controls [(12.15±3.04) mg/L vs (3.12±0.23) mg/L, P＜0.05], and also significantly higher in MHD patients as compared to non-HD patients [(16.89±3.35) mg/L vs (9.78±2.49) mg/L, P＜0.05].The atherosclerotic plaques incidence and IMT value of carotid artery increased significantly in CKD patients compared with healthy volunteers.Thrombomodulin was positively correlated with IMT in CKD patients (r=0.335, P＜0.01).Multiple stepwise regression analysis showed that thrombomodulin, Tm (OR=1.13, 95％CI 1.010-1.121), SBP (OR=1.09, 95％GI 1.009-1.114), CRP (OR=1.22, 95％CI 1.216-2.007), and Scr were independent risk factors of IMT. Conclusion Thrombomodulin is correlated with carotid atherosclerosis in CKD patients and may be used as a marker to evaluate the endothelial damage.
