中国血液净化

中国血液净化 ›› 2015, Vol. 14 ›› Issue (04): 224-226.doi: 10.3969/j.issn.1671-4091.2015.04.010

• 临床研究 • 上一篇    下一篇

血栓调节蛋白升高是维持性血液透析患者心血管疾病的危险因素

许武红1 ,邹原方2, 梁翔2   

  1. 1. 518000 深圳,1深圳市光明新区人民肾内科
    2. 523000 东莞,2中山大学附属东华医院肾内科
  • 收稿日期:2014-02-10 修回日期:2015-02-03 出版日期:2015-04-12 发布日期:2015-04-20
  • 通讯作者: 邹原方 zouyuanfang2008@163.com E-mail:zouyuanfang2008@163.com

Higher thrombomodulin level is a risk factor for cardiovascular diseases in maintenance hemodialysis patients

  • Received:2014-02-10 Revised:2015-02-03 Online:2015-04-12 Published:2015-04-20

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摘要： 目的  探讨维持性血液透析(maintenance hemodialysis,MHD)患者血栓调节蛋白(thrombomodulin, Tm)水平与心血管疾病(cardiovageular diseases,CVD)的相关性。方法采用回顾性研究，选取112 例MHD 患者为研究对象，同期健康体检者为对照组。用ELlSA 法检测Tm 水平，采用Spearman 相关分析Tm 与各实验参数的相关性，CVD 的危险因素采用Logistic 回归分析。结果共112 例MHD 患者入选，Tm 平均水平显著高于对照组[(15.34±4.07)mg/L vs.(3.58±1.26)mg/L,P＜0.05]；合并CVD 患者Tm 水平为(20.64±4.73)mg/L，显著高于非CVD 患者(12.06±3.87)mg/L(P＜0.05)；Tm 水平与舒张末期左室内径(LVDd)、舒张末期室间隔(IVSd)、舒张末期左室后壁厚度(LVPWd)、左室心肌重量指数(LVMI)呈正相关(r =0.427，P =0.037；r =0.486，P =0.032；r=0.579，P =0.023；r =0.516，P =0.025)，与左室射血分数(LVEF)呈负相关(r=-0.394，P=0.002)；多因素logistic 回归分析显示，Tm、CRP、低Hb 是MHD 患者CVD 的危险因素。结论MHD 患者Tm 水平显著升高，Tm 是患者CVD 危险因素标志物。

关键词: 血液透析, 血栓调节蛋白, 心血管疾病

Abstract: Objective To study the relationship between cardiovascular diseases (CVD) and serum thrombomodulin (Tm) level in maintenance hemodialysis (MHD) patients. Methods A total of 112 MHD cases were retrospectively analyzed. Serum Tm was measured by enzyme-linked immunosorbent assay (ELISA). The relationship between serum Tm level and other related laboratory parameters was analyzed. Logistic regression was used to analyze the risk factors for CVD. Results Serum Tm level increased in MHD patients as compared with that in normal controls (15.34±4.07 mg/L vs. 3.58±1.26 mg/L, P＜0.05). MHD patients with CVD had significantly higher Tm level (P＜0.05). Tm was positively correlated with left ventricular end- diastolic diameter (LVDd; r=0.427, P=0.037), interventricular septal thickness (IVSTd; r=0.486, P= 0.032), posterior wall diameter of left ventricle at end-diastolic period (LVPWd; r=0.579, P= 0.023), and left ventricular mass index (LVMI; r= 0.516, P=0.025), and was negatively correlated with ejection fraction of left ventricle (r=-0.394, P=0.002). Multivariate logistic regression showed that Tm, CRP, low Hb were the independent risk factors for CVD. Conclusions Serum Tm level was significantly higher in MHD patients. Higher Tm was an independent risk factor for CVD in MHD patients.

Key words: Hemodialysis, Thrombomodulin, Cardiovascular disease