中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
22期
26-29
,共4页
肾透析%可溶性肿瘤坏死因子样凋亡弱诱导因子%心血管事件
腎透析%可溶性腫瘤壞死因子樣凋亡弱誘導因子%心血管事件
신투석%가용성종류배사인자양조망약유도인자%심혈관사건
Renal dialysis%Soluble tumor necrosis factor-like weak inducer of apoptosis%Cardiovascular events
目的 探讨血浆可溶性肿瘤坏死因子样凋亡弱诱导因子(sTWEAK)蛋白在维持性血液透析(MHD)患者心血管事件发生过程中的意义.方法 选择MHD患者64例(MHD组),酶联免疫吸附试验法检测血浆sTWEAK蛋白,酶联免疫荧光法检测N-末端脑钠肽前体(NT-proBNP)、高敏C反应蛋白(hs-CRP),超声心动图测定左心室舒张末期内径(LVEDd)、左心室后壁厚度(LVPWT)、室间隔厚度(IVST)、左心室射血分数(LVEF),记录MHD患者的一般情况、临床各项指标及发生的心血管事件,随访观察2年.另选择同期健康体检者50例作为对照组.结果 MHD组血浆sTWEAK蛋白高于对照组[(589±122) ng/L比(346±127) ng/L],差异有统计学意义(P＜0.01).随访期间发生心血管事件12例,其中3例死亡.心血管事件患者血浆sTWEAK蛋白中位数为695 ng/L,非心血管事件患者血浆sTWEAK蛋白中位数为458 ng/L,两者比较差异有统计学意义(P＜0.01).MHD患者血浆sTWEAK蛋白与NT-proBNP呈正相关(r=0.698,P＜0.05).Logistic回归分析提示血浆sTWEAK蛋白是MHD患者心血管事件发生的危险因素.结论 血浆sTWEAK蛋白升高可能预测MHD患者心血管事件发生.
目的 探討血漿可溶性腫瘤壞死因子樣凋亡弱誘導因子(sTWEAK)蛋白在維持性血液透析(MHD)患者心血管事件髮生過程中的意義.方法 選擇MHD患者64例(MHD組),酶聯免疫吸附試驗法檢測血漿sTWEAK蛋白,酶聯免疫熒光法檢測N-末耑腦鈉肽前體(NT-proBNP)、高敏C反應蛋白(hs-CRP),超聲心動圖測定左心室舒張末期內徑(LVEDd)、左心室後壁厚度(LVPWT)、室間隔厚度(IVST)、左心室射血分數(LVEF),記錄MHD患者的一般情況、臨床各項指標及髮生的心血管事件,隨訪觀察2年.另選擇同期健康體檢者50例作為對照組.結果 MHD組血漿sTWEAK蛋白高于對照組[(589±122) ng/L比(346±127) ng/L],差異有統計學意義(P＜0.01).隨訪期間髮生心血管事件12例,其中3例死亡.心血管事件患者血漿sTWEAK蛋白中位數為695 ng/L,非心血管事件患者血漿sTWEAK蛋白中位數為458 ng/L,兩者比較差異有統計學意義(P＜0.01).MHD患者血漿sTWEAK蛋白與NT-proBNP呈正相關(r=0.698,P＜0.05).Logistic迴歸分析提示血漿sTWEAK蛋白是MHD患者心血管事件髮生的危險因素.結論 血漿sTWEAK蛋白升高可能預測MHD患者心血管事件髮生.
목적 탐토혈장가용성종류배사인자양조망약유도인자(sTWEAK)단백재유지성혈액투석(MHD)환자심혈관사건발생과정중적의의.방법 선택MHD환자64례(MHD조),매련면역흡부시험법검측혈장sTWEAK단백,매련면역형광법검측N-말단뇌납태전체(NT-proBNP)、고민C반응단백(hs-CRP),초성심동도측정좌심실서장말기내경(LVEDd)、좌심실후벽후도(LVPWT)、실간격후도(IVST)、좌심실사혈분수(LVEF),기록MHD환자적일반정황、림상각항지표급발생적심혈관사건,수방관찰2년.령선택동기건강체검자50례작위대조조.결과 MHD조혈장sTWEAK단백고우대조조[(589±122) ng/L비(346±127) ng/L],차이유통계학의의(P＜0.01).수방기간발생심혈관사건12례,기중3례사망.심혈관사건환자혈장sTWEAK단백중위수위695 ng/L,비심혈관사건환자혈장sTWEAK단백중위수위458 ng/L,량자비교차이유통계학의의(P＜0.01).MHD환자혈장sTWEAK단백여NT-proBNP정정상관(r=0.698,P＜0.05).Logistic회귀분석제시혈장sTWEAK단백시MHD환자심혈관사건발생적위험인소.결론 혈장sTWEAK단백승고가능예측MHD환자심혈관사건발생.
Objective To investigate the relationship between soluble tumor necrosis factor-like weak inducer of apoptosis levels (sTWEAK) and cardiovascular events in patients with maintenance hemodialysis (MHD).Methods A prospective cohort study was conducted in 64 MHD patients(MHD group).The plasma level of sTWEAK was measured by enzyme-linked immunosorbent assay,N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitive C-reactive protein (hs-CRP) levels were measured by enzyme-linked immunofluorescence method,left ventricular end-diastolic diameter (LVEDd),left ventricular posterior wall thickness (LVPWT),end-diastolic ventricular septal thickness (IVST),left ventricular ejection fraction (LVEF) was determined by echocardiography.The general situation,clinical indicators and occurrence of cardiovascular events of MHD patients were recorded and followed up for 2 years.Fifty healthy people were selected as control group.Results The plasma level of sTWEAK was higher in MHD group than that in control group [(589 ± 122) ng/L vs.(346 ± 127) ng/L],and there was significant difference (P＜ 0.01).During the follow-up period,12 patients underwent cardiovascular events(3 patients died).The plasma level of sTWEAK in cardiovascular event patients was significantly higher than that in non-cardiovascular event patients (695 ng/L vs.458 ng/L),and there was significant difference (P ＜ 0.01).The plasma level of sTWEAK was positively correlated with NT-proBNP in MHD patients(r =0.698,P ＜ 0.05).Logistic repression analysis showed that sTWEAK was the predictor of cardiovascular events of MHD patients.Conclusion The plasma level of sTWEAK probably predicts the ocurrence of cardiovascular event in MHD patients.
