›› 2009, Vol. 8 ›› Issue (4): 192-195.

• 论著 • 上一篇    下一篇

糖尿病腹膜透析患者动脉僵硬度及其影响因素

刘莎 张东亮 代文迪 尹道馨 刘文虎

  

  1. Department of Nephrology, Beijing Friendship Hospital, Beijing 100050, China
  • 收稿日期:2008-11-19 修回日期:1900-01-01 出版日期:2009-04-12 发布日期:2009-04-12
  • 通讯作者: 刘文虎

Arterial Stiffness and its Related Factors in Diabetic Nephropathy Patients with Peritoneal Dialysis

LIU Sha, ZHANG Dong-liang, DAI Wen-di,Yin Dao-xin. Liu Wen-hu   

  • Received:2008-11-19 Revised:1900-01-01 Online:2009-04-12 Published:2009-04-12

摘要:

【摘要】目的 探讨糖尿病肾病(DN)腹膜透析(PD)患者动脉僵硬度及其影响因素。方法 测定45例DN及53例非糖尿病肾病(NDN)PD患者白蛋白(ALB)、C反应蛋白(CRP)、血红蛋白(Hb)、甘油三酯(TG)、总胆固醇(TC)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、全段甲状旁腺素(iPTH)、血钙及血磷水平,计算钙磷乘积(Ca×P)、尿素清除指数(Kt/V),测定丙二醛(MDA)、晚期氧化蛋白产物(AOPP)、髓过氧化物酶(MPO)及超氧化物歧化酶(SOD)水平,并应用超声测量计算各组颈动脉内中膜复合体厚度(IMT)、弹性指数(Ep)、僵硬指数(SI)。结果 两组患者血清ALB、CRP、Hb、FPG、HbA1c、Kt/V、MDA、AOPP、MPO、SOD、IMT、Ep、SI间差别有统计学意义(P<0.05),DN组多元逐步回归分析显示HbA1c、MDA、AOPP、MPO、SOD水平对EP、SI水平有显著性影响(P<0.05),相关分析表明IMT、Ep、SI各自分别与HbA1c、MDA、AOPP、MPO水平呈正相关关系(P<0.05),与SOD水平呈负相关关系(P<0.05),HbA1c水平分别与MDA、AOPP、MPO水平呈正相关关系,与SOD水平呈负相关关系(P<0.05)。结论 DN PD患者比NDN PD患者动脉僵硬度水平更高;糖化血红蛋白、氧化应激水平能影响DN PD患者动脉僵硬度,且二者之间存在密切关系。

关键词: 糖尿病肾病, 腹膜透析, 动脉僵硬度, 糖化血红蛋白, 氧化应激

Abstract:

【Abstract】 Objective To explore arterial stiffness and its related factors in diabetic nephropathy patients treated with peritoneal dialysis (PD). Methods Serum albumin (ALB), C reactive protein (CRP), hemoglobin (Hb), triglycerides (TG), total cholesterol (TC), fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), intact PTH (iPTH), Ca+2, Kt/V, malondialdehyde (MDA), advanced oxidation protein products (AOPP), myeloperoxidase (MPO) and superoxide dismutase (SOD) levels were assayed, and intima-media thickness (IMT), pressure-strain elastic modulus (Ep) and stiffness index (SI) of carotid arteries were measured by ultrasound examination in 45 diabetic nephropathy patients and 53 non-diabetic nephropathy patients with PD. Results ALB, CRP ,Hb, FPG, HbA1c, Kt/V, MDA, AOPP, MPO, SOD, IMT, Ep and SI were significantly different between the two groups (P<0.05). Multiple linear stepwise regression analysis revealed that EP and SI were influenced by the levels of HbA1c, MDA, AOPP, MPO and SOD. In diabetic nephropathy patients with PD, correlation analysis showed that IMT, Ep and SI were positively correlated with the levels of HbA1c, MDA, AOPP and MPO, and were negatively correlated with SOD level, while HbA1c was positively correlated with the levels of MDA, AOPP and MPO, and was negatively correlated with SOD level. Conclusion Arterial stiffness is worse in diabetic nephropathy patients with PD than in non-diabetic nephropathy patients with PD. HbA1c and oxidative stress closely relate to the arterial stiffness degree in diabetic nephropathy patients with PD.

Key words: Peritoneal dialysis, Arterial stiffness, Glycosylated hemoglobin, Oxidative stress