中国血液净化

›› 2005, Vol. 4 ›› Issue (10): 527-528.

• 论著 • 上一篇    下一篇

血液透析患者透析充分性与颈动脉粥样硬化的关系

曹礼应 肖丽佳 余月明 王柏青 余开慧 郭 虹 段 建
  

  1. 650032 昆明，成都军区昆明总医院肾内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2005-10-12 发布日期:2005-10-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2005-10-12 Published:2005-10-12

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摘要： 目的 探讨维持性血液透析(HD)患者透析充分性与颈动脉粥样硬化(AS)的关系。方法 收集成都军区总医院肾内科行HD的75例患者，检测75例HD患者一般临床指标、C-反应蛋白(CRP)水平，应用高分辨彩色B超测患者颈动脉内膜-中层厚度(IMT)及粥样硬化斑块，按患者标准化蛋白分解率(nPCR)水平分为nPCR≥1.0组及＜1.0组，分析两组患者临床指标及颈动脉硬化情况。结果 nPCR≥1.0组患者尿素氮(BUN)、血肌酐(Scr)、总蛋白(TP)、白蛋白(Alb)、尿素清除率(Kt/V)显著高于nPcR ＜1.0组而患者CRP、颈动脉平均IMT、颈动脉增厚阳性率、斑块阳性率显著低于nPCR＜1.0组；HD患者nPCR与CRP、Alb、BUN、Scr、颈动脉平均IMT显著相关，患者CRP与Alb颈动脉平均IMT显著相关。结论 nPCR为HD患者透析充分性、营养状况的有用指标，与炎症状态、颈动脉硬化及营养状况有关，炎症、营养不良、动脉硬化互为因果，炎症可能为中心环节。

关键词: 血液透析, 标准化蛋白分解率, 动脉粥样硬化, C-反应蛋白

Abstract:

Objective To investigate the relationship between carotid atherosclerosis(AS) and dialysis adequacy in hemodialysis(HD) patients.Methods Seventy-five HD patients were enrolled in this study. Clinical indexes and serum C－reactive protein (CRP) were measured, and intima-media thickness(IMT) of extracranial carotid artery and presence of atherosclerotic plaques were examined by high-resolution B-mode ultrasonography. Two groups were divided according to normalized protein catabolic rate(nPCR). Results The blood urea nitrogen(BUN), serum creatinine（Scr）, total protein(TP), serum albumin(Alb), Kt/V in nPCR≥1.0 group with HD were significantly higher than nPCR＜1.0 group, and CRP, mean IMT, incidence of plaque occurrence and increased IMT were significantly increased in nPCR＜1.0 group. There was relationship between nPCR and CRP, Alb, BUN, Scr and mean IMT in HD patients. Conclusions nPCR is a helpful index to estimate the dialyisi adequacy and malnutrition in HD patients. There was relationship between nPCR and micro-inflammation, carotid AS and malnutrition. The microin-flammation, carotid AS and malnutri-tion influenced each other, Microin-flammation is the center link among those factors.

Key words: Normalized protein catabolic rate, Atherosclerosis, C－reactive protein

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