CAJ | 학술논문

目的为了解维持性血液透析(MHD)患者微炎症状态、胰岛素抵抗及其与动脉粥样硬化(AS)的关系.方法对101例MHD患者的临床资料进行分析,包括微炎症指标超敏C-反应蛋白、胰岛素抵抗HOMA-IR指数与动脉粥样硬化的关系.结果动脉硬化组与无动脉硬化组比较,血浆白蛋白、前白蛋白和总胆固醇较低,P ＜0.01；而血糖、胰岛素、HOMA指数和C肽等则高于无动脉硬化组,P＜0.01.动脉硬化组有32.4％的患者有胰岛素抵抗,而无动脉硬化组胰岛素抵抗仅占1.7％,P＜0.01.Logistic回归分析发现,患者年龄、hsCRP和HOMA-IR增高是动脉粥样硬化的独立风险因素,而总胆固醇对动脉粥样硬化有保护作用.结论 MHD患者的年龄、微炎症状态及IR与AS密切相关,应作为降低MHD患者心脑血管并发症的治疗靶点.
목적 위료해유지성혈액투석(MHD)환자미염증상태、이도소저항급기여동맥죽양경화(AS)적관계.방법 대101례MHD환자적림상자료진행분석,포괄미염증지표초민C-반응단백、이도소저항HOMA-IR지수여동맥죽양경화적관계.결과 동맥경화조여무동맥경화조비교,혈장백단백、전백단백화총담고순교저,P ＜0.01；이혈당、이도소、HOMA지수화C태등칙고우무동맥경화조,P＜0.01.동맥경화조유32.4％적환자유이도소저항,이무동맥경화조이도소저항부점1.7％,P＜0.01.Logistic회귀분석발현,환자년령、hsCRP화HOMA-IR증고시동맥죽양경화적독립풍험인소,이총담고순대동맥죽양경화유보호작용.결론 MHD환자적년령、미염증상태급IR여AS밀절상관,응작위강저MHD환자심뇌혈관병발증적치료파점.
Objectives To understand the relationship of micro-inflammation,insulin resistance and atherosclerosis in the patients on maintenance hemodialysis.Methods The clinical data of 101 patients on maintenance hemodialysis was analyzed,including inflammation maker such as high sensitive C reactive protein (hsCRP),insulin resistance index such as HOMA-IR,and atherosclerosis diagnosed by carotid artery Doppler ultrasonography and eyeground artery manifestation.Results In the patients in atherosclerosis group compared with the patients in non-atherosclerosis groups,the levels of plasma albumin,prealbumin,and total cholesterol were lower(P ＜0.01),but the levels of blood glucose,insulin,HOMA-IR and C peptide were significantly higher(P ＜0.01).By analyzed with binary logistic,age,hsCRP,and HOMA-IR were independent risk factors of atherosclerosis and total cholesterol was the protective factor of atheroaclerosis.Conclusions The age,the statue micro-inflammation and insulin resistance are associated with atherosclerosis and to be the targets of prevention cardiovascular and cerebrovascular complications in the patients on maintenance dialysis.