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

中国血液净化 ›› 2005, Vol. 4 ›› Issue (10) : 527-528.

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PDF(283 KB)
中国血液净化 ›› 2005, Vol. 4 ›› Issue (10) : 527-528.
论著

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
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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。

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.

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

Key words

Normalized protein catabolic rate / Atherosclerosis / C-reactive protein

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曹礼应 肖丽佳 余月明 王柏青 余开慧 郭 虹 段 建. 血液透析患者透析充分性与颈动脉粥样硬化的关系[J]. 中国血液净化. 2005, 4(10): 527-528
中图分类号: R446.6   

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