维持性血液透析患者C反应蛋白、肿瘤坏死因子α与心脏结构和功能的相关分析

刘 虹; 彭佑铭; 陈星; 蒋琼; 刘伏友

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中国血液净化 ›› 2006, Vol. 5 ›› Issue (6) : 313-315.

论著

维持性血液透析患者C反应蛋白、肿瘤坏死因子α与心脏结构和功能的相关分析

刘虹彭佑铭陈星蒋琼刘伏友

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摘要

目的了解维持性血液透析患者C反应蛋白、肿瘤坏死因子α与心脏结构和功能之间的相关关系。方法选择中南大学湘雅二医院肾内科58例维持性血液透析患者及58例配对健康对照者,测定血C反应蛋白(CRP)、肿瘤坏死因子α(TNFα)，并用超声心动图测定患者心脏的左心室内径(LVD)、左心房内径(LAD)、左心室后壁厚度(LVPWT)、室间隔厚度(IVST)、左心室射血分数(LVEF)等。结果维持性血液透析患者CRP、TNFα较对照组明显升高(P＜0.05)。维持性血液透析患者LVD,LAD ,左心室心肌质量指数(LVMI)明显高于正常对照组(P＜0.01), IVST 和LVPWT 高于正常对照组(P＜0.05),LVEF 明显低于对照组(P＜0.05)。CRP、TNFα与与LVD, LAD, LVPWT, IVST等呈正相关,与LVEF 呈负相关；CRP与TNFα呈正相关(P＜0.01)。结论微炎症可能参与了维持性血液透析患者心血管并发症的发生与发展。

Abstract

Objective To analyze the relationship between C reactive protein (CRP)，tumor necrosis factor α(TNF-a) and cardiac structure and function in maintenance hemodialysis patients. Methods The levels of CRP and TNFα in 58 maintenance hemodialysis patients and 58 paired control subjects were measured and the left ventricular diameter (LVD), left atrial diameter (LAD) left ventriadar mass imdex (LVMI), left ventricular posterior wall thickness(LVPWT), interventricular septal thickness (IVST), and left ventricular ejection fraction (LVEF) were also detected by ultrasonic cardiography. Results　The levels of CRP and TNFαincreased significantly (P ＜0. 05) in maintenance hemodialysis patients compared with the control subjects. LVD,LAD,LVMI, IVST, and LVPWT increased significantly, while LVEF decreased significantly (P ＜0. 05). The levels of CRP and TNFαwere positively correlated with the levels of LVD, LAD, LVPWT, and IVST in the uremic patients , while negatively correlated with the levels of LVEF. The levels of CRP positively correlated with the levels of TNFα. Conclusion CRP and TNFαare probably involved in the presence and the progression of cardiovascular complications in maintenance hemodialysis patients.