中国血液净化

中国血液净化 ›› 2012, Vol. 11 ›› Issue (2): 68-72.doi: 10.3969/j.issn.1671-4091.2012.01.00

• 临床研究 • 上一篇    下一篇

慢性肾脏病患者外周血CD36的表达及其临床意义

方燕1,张俞2,钱家麒1,戴慧莉1,王琴1,牟珊1,倪兆慧1,严玉澄   

  1. 200127 上海，1上海交通大学医学院附属仁济医院肾脏科; 200127 上海，2 上海交通大学附属第一人民医院重症监护病房
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2012-02-12 发布日期:2012-02-12
  • 通讯作者: 严玉澄 yucheng.yan@163.com
  • 基金资助:

    上海科学技术委员会重大科技专题攻关项目(08dzl900501)

The expression of peripheral blood CD36 and its clinical significance in patients with chronic kidney disease

FANG Yan , ZHANG Yu, QIAN Jia-qi , DAI Hui-li , WANG Qin , MOU Shan1 , NI Zhao-hui1 , YAN Yu-cheng   

  • Received:1900-01-01 Revised:1900-01-01 Online:2012-02-12 Published:2012-02-12

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摘要： 【摘要】目的 探讨慢性肾脏病(chronic kidney disease，CKD)患者外周血CD36的表达情况及其可能的影响因素，并观察其与患者的临床心血管疾病的关系。 方法  选取上海交通大学医学院附属仁济医院77例CKD患者和10例健康志愿者，收集患者的临床资料，并进行血生化、超声心动图和颈动脉超声检查，流式细胞仪检测外周血CD36水平，比较CKD1～3期、CKD4～5期患者和对照组患者外周血CD36水平，并分析其与血脂代谢、炎症指标、颈动脉斑块及左心室肥厚的关系。 结果  CKD 1～3期组(n=36)、CKD 4～5期组(n=41)和对照组患者的外周血CD36的绝对计数分别为476.73±191.41×105/L、1463.61±592.90×105/L和68.55±12.73×105/L，CKD 4～5期组患者的外周血CD36水平显著高于CKD 1-3期组患者(P＜0.01)，CKD l～3期组又显著高于健康对照组(P＜ 0.01)。左心室肥大患者的CD36水平显著高于非左心室肥大患者(1255.07±704.20×105/L 比 805.34±586.20×105/L，P＜0.05)。多元回归分析显示，CD36是影响颈动脉斑块形成的独立危险因素(b=0.295，P=0.010)。逐步多元线性回归分析显示，eGFR (β= -0.301)和三酰甘油(β=-0.294)是影响CKD患者外周血CD36水平的独立危险因素(P值均＜0.01)。 结论  CKD患者的外周血CD36水平显著升高，其与患者的肾功能减退和脂质代谢紊乱密切相关，可能造成动脉粥样斑块的形成及左心室肥大的发生。

Abstract: 【Abstract】Objective To investigate the expression of peripheral blood CD36 level, its influence factors, and its clinical significance in patients with chronic kidney disease. Methods A total of 77 chronic kidney disease (CKD) patients and 10 healthy subjects were included in this study. Clinical data was collected. Blood tests, echocardiogram and carotid artery ultrasound were taken. The number of CD36+ cells in whole blood was determined by a flow cytometer and compared among patients with CKD stage 1～3, Stage 4～5 and healthy subjects. Its correlations with lipid, inflammation indices, carotid plaques and left ventricular hypertrophy were analyzed.  Results The CD36+ level was significantly higher in patients at CKD stage 1～3 and CKD stage 4～5 than in control subjects (476.73±191.41×105/L, 1463.61±592.90×105/L and 68.55±12.73×105/L, respectively, P＜0.01), and was significantly higher in patients at CKD stage 4～5 than in patients at CKD stage 1～3 (P＜0.01). The CD36+ level was significantly higher in patients with left ventricular hypertrophy than in those without left ventricular hypertrophy (1255.07±704.20×105/L vs. 805.34±586.20×105 / L, P＜0.05). Multiple regression analysis showed that the CD36+ level in whole blood was an independent risk factor for carotid artery plaque (β=0.295, P=0.010). Multiple linear regression analysis showed that eGFR (β= -0.301, P＜0.01) and triglyceride (β= -0.294, P＜0.01) were the stronger independent determinants of the CD36+ level.  Conclusion The CD36+ level in whole blood was elevated in CKD patients. The increase of CD36+ level was closely associated with renal function deterioration and dyslipidemia, and might relate to left ventricular hypertrophy and atherosclerosis.