中国血液净化

中国血液净化 ›› 2013, Vol. 12 ›› Issue (06): 293-296.doi: 10.3969/j.issn.1671-4091.2013.06.00

• 临床研究 • 上一篇    下一篇

维持性血液透析患者慢性炎症与心脏重构和心功能关系的研究

王菁,刘丽秋   

  1. 青岛大学医学院
  • 收稿日期:2011-09-05 修回日期:2013-04-26 出版日期:2013-06-12 发布日期:2013-07-01
  • 通讯作者: 王菁 13953522065@163.com E-mail:13953522065@163.com

Investigation of the correlation of chronic inflammation and cardiac structure and function in maintenance hemodialysis patients.

  • Received:2011-09-05 Revised:2013-04-26 Online:2013-06-12 Published:2013-07-01

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摘要： 【摘要】目的：探讨维持性血液透析患者血清中炎性因子水平与患者心脏结构及功能变化的关系。方法：检测患者血清中超敏C反应蛋白（hsCRP）、白介素6（IL-6）、肿瘤坏死因子α（TNF-α）的水平，并将实验组中患者分为hsCRP 正常组和hsCRP 升高组；彩色多普勒超声诊断仪测定两组患者左心房前后径(LAD)、左心室舒张期内径(LVDd)、左心室收缩期内径(LVDs)、左心室舒张期后壁厚度(LVPWT)、室间隔厚度(IVST)、左心室质量指数(LVMI)、左心室射血分数(LVEF)、二尖瓣前向血流E峰与A 峰比值(E/A),测量心排出量(CO)；结果：与hsCRP 正常组相比, hsCRP 升高组血清中IL6和TNF-α水平均较高，差异具有统计学意义(P<0.01) ；hsCRP 升高组患者 LAD、LVDd、LVDs、LVPWT、IVST 和LVMI均高于hsCRP正常组( P< 0.05) , hsCRP升高组LVEF、E/A和CO 低于hsCRP正常组(P<0.01)；hsCRP 升高组左心室肥厚、左心室收缩功能减退及左心室顺应性下降发生率高于hsCRP 正常组(P<0.01)；血清炎症因子与心超指标的相关性分析发现：hsCRP、IL6、T NF-α分别与LAD、LVDd、LVDs、LVPWT、IVST、LVMI呈正相关(P< 0.05)。hsCRP、IL6、TNFα分别与LVEF、E/A、CO 呈负相关, 白蛋白与LVEF呈负相关(P< 0.05) , hsCRP与IL6、TNFα呈正相关(P< 0. 05)。结论：维持性血液透析患者血清中炎性因子水平可能与患者心脏结构及功能变化具有一定的相关性，能够为终末期肾脏疾病的诊治提供一定的提示作用。

关键词: 血液透析, 炎性因子, 心功能

Abstract: 【Abstract】Objective: To investigate the relationship between the level of inflammation factors in blood serum and the heart construction and function from CHD patients.Methods: To detect the levels of hsCRP, IL-6, TNF-α in in blood serum from CHD patients. The patients were divided into two experiment groups depending on the level of hsCRP, the normal group and the abnormal group. The parameters of LAD, LVDd, LVDs, LVPWT, IVST, LVMI, LVEF, E/A, CO were measured from the two experiment groups by color Doppler ultrasonoscope.Results: Compared with the normal hsCRP group, patients have high levels of IL-6 and TNF-α in in blood serum from abnormal hsCRP group(P<0.01).Contrast to the normal hsCRP group, the levels of LAD, LVDd, LVDs, LVPWT, IVST and LVMI from abnormal hsCRP group is more higher than that from normal group( P< 0.05). The incidence of left ventricular disfunction, including hypertrophy, contractile hypofunction, ventricular compliance from abnormal hsCRP group is more higher than that from normal group( P< 0.01). The dependability analysis between inflammation factors in blood serum and the heart parameters showed that the levels of hsCRP, IL6,T NF-αhave positive correlation with LAD、LVDd、LVDs、LVPWT、IVST、LVMI (P< 0.05), but negative correlation with LVEF、E/A、CO (P< 0.05). And the level of hsCRP has positive correlation with IL-6 and T NF-α(P< 0.05).Conclusion: The level of inflammation factors in blood serum maybe is correlative to the heart construction and function from CHD patients, which is helpful to the diagnose and therapy for ESRD patients.

Key words: Hemodialysis, Inflammation, Cardiac function