安徽医学
安徽醫學
안휘의학
Anhui Medical Journal
2015年
11期
1346-1349
,共4页
腹膜透析%心室重构%基质金属蛋白酶-10%基质金属蛋白酶-8%基质金属蛋白酶组织抑制剂-1
腹膜透析%心室重構%基質金屬蛋白酶-10%基質金屬蛋白酶-8%基質金屬蛋白酶組織抑製劑-1
복막투석%심실중구%기질금속단백매-10%기질금속단백매-8%기질금속단백매조직억제제-1
Peritoneal Dialysis%Ventricular Remodeling%Matrix Metalloproteinase-10%Matrix Metalloproteinase-8%Tissue Inhibitor of Metalloproteinase-1
目的：了解持续不卧床腹膜透析（CAPD）患者心室重构情况及其与血清基质金属蛋白酶-10（MMP-10）、基质金属蛋白酶-8（MMP-8）、基质金属蛋白酶组织抑制剂-1（TIMP-1）浓度的关系。方法选取肾内科住院 CAPD 及临床符合诊断慢性肾脏病（CKD）患者135例，分为 CKD3、CKD4、CKD5期组和 CAPD 组，其中 CAPD 组68例；多普勒心脏彩超仪测量左室舒张末内径（LVDd）、室间隔厚度（IVST）、左室后壁厚度（LVPWT），计算左室质量指数（LVMI）和左室相对厚度（RLVT）；血清 MMP-10，MMP-8， TIMP-1检测采用酶联免疫吸附试验。结果 CAPD 组 IVST 值最大，与 CKD3、CKD4期组比较差异有统计学意义（P <0.05），CAPD组中 IVST 增厚占38.23%；CAPD 组 LVDd 值低于 CKD5期患者，差异无统计学意义，较 CKD3、CKD4期组显著升高，差异有统计学意义（P <0.05）。CAPD 患者存在左室肥厚（LVH）及向心性肥厚均占48.53%；CAPD 患者血清 MMP-10，MMP-8，TIMP-1浓度明显高于 CKD3、CKD4、CKD5期患者；CAPD 患者中 IVST 增厚组 MMP-10，MMP-8，TIMP-1浓度较 IVST 正常组均增高，仅 MMP-10比较差异有统计学意义（P <0.05）；CAPD 患者中向心性肥厚组和无向心性肥厚组 MMP-10，MMP-8，TIMP-1比较差异无统计学意义（P >0.05）。CAPD 患者中 LVH 组 MMP-10，MMP-8，TIMP-1水平高于无 LVH 组，但差异无统计学意义（P >0.05）；Spearman 直线相关分析提示 IVST 与 MMP-10（r =0.382，P =0.010），TIMP-1（r =0.252，P =0.038）成正相关，与 MMP-8无相关性，RLVT 与 MMP-10成正相关（r =0.243，P =0.045），LVDd、LVMI 与 MMP-10，MMP-8，TIMP-1间关联无统计学意义（P >0.05）。结论 CAPD 患者心室重构较早期 CKD 患者明显；CAPD 可能不能逆转尿毒症患者已经存在的心室重构；MMP-10，TIMP-1与心室重构之间具有相关性。
目的：瞭解持續不臥床腹膜透析（CAPD）患者心室重構情況及其與血清基質金屬蛋白酶-10（MMP-10）、基質金屬蛋白酶-8（MMP-8）、基質金屬蛋白酶組織抑製劑-1（TIMP-1）濃度的關繫。方法選取腎內科住院 CAPD 及臨床符閤診斷慢性腎髒病（CKD）患者135例，分為 CKD3、CKD4、CKD5期組和 CAPD 組，其中 CAPD 組68例；多普勒心髒綵超儀測量左室舒張末內徑（LVDd）、室間隔厚度（IVST）、左室後壁厚度（LVPWT），計算左室質量指數（LVMI）和左室相對厚度（RLVT）；血清 MMP-10，MMP-8， TIMP-1檢測採用酶聯免疫吸附試驗。結果 CAPD 組 IVST 值最大，與 CKD3、CKD4期組比較差異有統計學意義（P <0.05），CAPD組中 IVST 增厚佔38.23%；CAPD 組 LVDd 值低于 CKD5期患者，差異無統計學意義，較 CKD3、CKD4期組顯著升高，差異有統計學意義（P <0.05）。CAPD 患者存在左室肥厚（LVH）及嚮心性肥厚均佔48.53%；CAPD 患者血清 MMP-10，MMP-8，TIMP-1濃度明顯高于 CKD3、CKD4、CKD5期患者；CAPD 患者中 IVST 增厚組 MMP-10，MMP-8，TIMP-1濃度較 IVST 正常組均增高，僅 MMP-10比較差異有統計學意義（P <0.05）；CAPD 患者中嚮心性肥厚組和無嚮心性肥厚組 MMP-10，MMP-8，TIMP-1比較差異無統計學意義（P >0.05）。CAPD 患者中 LVH 組 MMP-10，MMP-8，TIMP-1水平高于無 LVH 組，但差異無統計學意義（P >0.05）；Spearman 直線相關分析提示 IVST 與 MMP-10（r =0.382，P =0.010），TIMP-1（r =0.252，P =0.038）成正相關，與 MMP-8無相關性，RLVT 與 MMP-10成正相關（r =0.243，P =0.045），LVDd、LVMI 與 MMP-10，MMP-8，TIMP-1間關聯無統計學意義（P >0.05）。結論 CAPD 患者心室重構較早期 CKD 患者明顯；CAPD 可能不能逆轉尿毒癥患者已經存在的心室重構；MMP-10，TIMP-1與心室重構之間具有相關性。
목적：료해지속불와상복막투석（CAPD）환자심실중구정황급기여혈청기질금속단백매-10（MMP-10）、기질금속단백매-8（MMP-8）、기질금속단백매조직억제제-1（TIMP-1）농도적관계。방법선취신내과주원 CAPD 급림상부합진단만성신장병（CKD）환자135례，분위 CKD3、CKD4、CKD5기조화 CAPD 조，기중 CAPD 조68례；다보륵심장채초의측량좌실서장말내경（LVDd）、실간격후도（IVST）、좌실후벽후도（LVPWT），계산좌실질량지수（LVMI）화좌실상대후도（RLVT）；혈청 MMP-10，MMP-8， TIMP-1검측채용매련면역흡부시험。결과 CAPD 조 IVST 치최대，여 CKD3、CKD4기조비교차이유통계학의의（P <0.05），CAPD조중 IVST 증후점38.23%；CAPD 조 LVDd 치저우 CKD5기환자，차이무통계학의의，교 CKD3、CKD4기조현저승고，차이유통계학의의（P <0.05）。CAPD 환자존재좌실비후（LVH）급향심성비후균점48.53%；CAPD 환자혈청 MMP-10，MMP-8，TIMP-1농도명현고우 CKD3、CKD4、CKD5기환자；CAPD 환자중 IVST 증후조 MMP-10，MMP-8，TIMP-1농도교 IVST 정상조균증고，부 MMP-10비교차이유통계학의의（P <0.05）；CAPD 환자중향심성비후조화무향심성비후조 MMP-10，MMP-8，TIMP-1비교차이무통계학의의（P >0.05）。CAPD 환자중 LVH 조 MMP-10，MMP-8，TIMP-1수평고우무 LVH 조，단차이무통계학의의（P >0.05）；Spearman 직선상관분석제시 IVST 여 MMP-10（r =0.382，P =0.010），TIMP-1（r =0.252，P =0.038）성정상관，여 MMP-8무상관성，RLVT 여 MMP-10성정상관（r =0.243，P =0.045），LVDd、LVMI 여 MMP-10，MMP-8，TIMP-1간관련무통계학의의（P >0.05）。결론 CAPD 환자심실중구교조기 CKD 환자명현；CAPD 가능불능역전뇨독증환자이경존재적심실중구；MMP-10，TIMP-1여심실중구지간구유상관성。
Objective To investigate the status of ventricular remodeling in continuous ambulatory peritoneal dialysis(CAPD)pa-tients and its correlation with serum concentrations of matrix metalloproteinase-10(MMP-10),matrix metalloproteinase-8(MMP-8),tissue inhibitor of metalloproteinase-1(TIMP-1). Methods 135 cases from the hospitalized patients,who were diagnosed with CAPD or chronic kidney disease(CKD),were enrolled in the study. They were divided into four groups:CAPD group(68 patients),CKD3 stage group, CKD4 stage group and CKD5 stage group. Left ventricular diastolic diameter(LVDd),interventricular septum thickness(IVST),left ven-tricular posterior wall thickness(LVPWT)were estimated by color Doppler ultrasonic cardiogram so as to calculate left ventricular mass index (LVMI)and relative left ventricular wall thickness(RLVT). The serum levels of MMP-10,MMP-8 and TIMP-1 were measured by ELISA. Results In the CAPD group,patients with thickened IVST accounted for 38. 23% and had the thickest IVST,with significant difference when compared with that in the CKD3 and CKD4 groups(P < 0. 05). The value of LVDd in the CAPD group was lower than that in the CKD5 group without significant difference,but was significantly higher than that in the CKD3 and CKD4 groups(P < 0. 05). Patients with left ventricular hypertrophy(LVH)and concentric hypertrophy each accounted for 48. 53% in the CAPD group,and their serum MMP-10, MMP-8 and TIMP-1 concentrations were much higher than those in the CKD group. Compared with the normal IVST subgroup,patients in the thickened IVST subgroup had higher serum MMP-10,MMP-8 and TIMP-1 concentrations,but only comparison of MMP-10 had statistical sig-nificance(P < 0. 05). There was no significant difference between the serum MMP-10,MMP-8 and TIMP-1 levels of concentric and non-con-centric hypertrophy patients in the CAPD group. Similarly,no significant difference was found between the serum MMP-10,MMP-8 and TIMP-1 levels of LVH and non-LVH patients. The spearman linear correlation analysis in the CAPD group showed that,IVST value was posi-tively related with serum MMP-10(r = 0. 382,P = 0. 010),TIMP-1(r = 0. 252,P = 0. 038)concentrations except MMP-8,and RLVT value was positively related with serum MMP-10(r = 0. 243,P = 0. 045)concentration,but correlation between LVDd and LVMI values and serum MMP-10,MMP-8,TIMP-1 concentrations was of no statistical significance. Conclusion The ventricular remodeling in the CAPD patients is more significant than that in the early CKD patients,and the existing remodeling in uremia patients could probably not be reversed by CAPD. There are correlation between ventricular remodeling in CAPD patients and serum levels of MMP-10 and TIMP-1.
