不同腹膜轉(zhuǎn)運(yùn)特性對(duì)腹膜透析患者血管內(nèi)皮功能及CRP、Hcy的影響
發(fā)布時(shí)間：2018-08-25 15:27
【摘要】：目的:本文采用肱動(dòng)脈FMD作為評(píng)估血管內(nèi)皮功能的指標(biāo),超敏C反應(yīng)蛋白(CRP)為衡量微炎癥的指標(biāo),觀察不同腹膜轉(zhuǎn)運(yùn)特性對(duì)血管內(nèi)皮功能及CRP、Hcy的影響,為評(píng)估心血管事件提供臨床依據(jù)。方法:選取2015年1月~2016年12月山西醫(yī)科大學(xué)第一醫(yī)院腎內(nèi)科,行持續(xù)性不臥床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者70例,按照腹膜平衡(PET)試驗(yàn)分為2組,即高轉(zhuǎn)運(yùn)組和低轉(zhuǎn)運(yùn)組,分別記錄患者的一般情況,檢測(cè)患者血漿超敏CRP及同型半胱氨酸(Hcy),同時(shí)檢測(cè)血肌酐(Scr)、血尿素(BUN)、血清白蛋白(ALB)、血鈣(Ca)、血磷(P)、甲狀旁腺激素(iPTH)等生化指標(biāo),采用肱動(dòng)脈血流介導(dǎo)的血管擴(kuò)張(FMD)評(píng)估血管內(nèi)皮功能,分析不同腹膜轉(zhuǎn)運(yùn)特性對(duì)血管內(nèi)皮功能及CRP、Hcy的影響。應(yīng)用SPSS 19.0軟件包進(jìn)行統(tǒng)計(jì)分析。結(jié)果:1.兩組患者在性別、年齡、體質(zhì)指數(shù)(BMI)、透析齡上,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),Ca、P、i PTH、BUN和Scr差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);與低轉(zhuǎn)運(yùn)組相比,高轉(zhuǎn)運(yùn)組患者的ALB顯著降低,差異具有統(tǒng)計(jì)學(xué)意義(P0.01)。2.兩組患者的原發(fā)病差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。3.高轉(zhuǎn)運(yùn)組FMD值(3.96±1.11)%低于低轉(zhuǎn)運(yùn)組FMD(6.05±0.95)%(P0.01);高轉(zhuǎn)運(yùn)組CRP水平中位數(shù)(3.88)mg/L高于低轉(zhuǎn)運(yùn)組(2.82)mg/L(P0.05);高轉(zhuǎn)運(yùn)組Hcy(29.88±2.25)mol/L低于低轉(zhuǎn)運(yùn)組(31.90±2.21)mol/L,差異均有統(tǒng)計(jì)學(xué)意義(P0.01)。4.PD患者的FMD值與CRP水平呈負(fù)相關(guān)(r=-0.235,P0.01),FMD與Hcy無(wú)相關(guān)性(P0.05)。結(jié)論:1.PD患者均存在不同程度的血管內(nèi)皮功能紊亂,高轉(zhuǎn)運(yùn)組的紊亂程度較高,且血管內(nèi)皮功能紊亂與CRP水平密切相關(guān),提示改善PD患者的微炎癥狀態(tài)可以改善其血管內(nèi)皮功能的紊亂程度。2.PD患者常存在高Hcy血癥,而腹膜高轉(zhuǎn)運(yùn)患者的Hcy水平普遍低于低轉(zhuǎn)運(yùn)者,可能與PD對(duì)Hcy的清除有關(guān)。3.控制PD患者尤其是腹膜高轉(zhuǎn)運(yùn)患者的血管內(nèi)皮功能紊亂及體內(nèi)的微炎癥水平,對(duì)降低心血管事件具有重要意義。
[Abstract]:Aim: to evaluate the endothelial function of brachial artery by using FMD and (CRP) as the index of microinflammation, and to observe the effects of different peritoneal transport characteristics on endothelial function and CRP,Hcy. To provide clinical basis for evaluating cardiovascular events. Methods: from January 2015 to December 2016, 70 patients with continuous ambulatory peritoneal dialysis (continuous ambulatory peritoneal dialysis,CAPD) in the Department of Renal Medicine, first Hospital of Shanxi Medical University, were divided into two groups according to peritoneal equilibrium (PET) test: high transport group and low transport group. The plasma hypersensitive CRP and homocysteine (Hcy), were measured respectively. The serum creatinine, (Scr), blood urea, (BUN), serum albumin, (ALB), (Ca), serum phosphorus, (P), parathyroid hormone (iPTH) were detected. The vascular endothelial function was evaluated by brachial artery vasodilation (FMD), and the effects of different peritoneal transport characteristics on vascular endothelial function and CRP,Hcy were analyzed. SPSS 19.0 software package was used for statistical analysis. The result is 1: 1. There was no significant difference in gender, age and BMI (BMI), dialysis age between the two groups (P0.05). There was no significant difference in PTH,BUN and Scr between the two groups (P0.05). Compared with the low transport group, the ALB in the high transport group was significantly lower than that in the low transport group (P0.01). 2. There was no significant difference in primary disease between the two groups (P0.05). 3. The FMD value of high transport group (3.96 鹵1.11)% was lower than that of low transport group (6.05 鹵0.95)% (P0.01), the median CRP level of high transport group (3.88) mg/L was higher than that of low transport group (2.82) mg/L (P0.05), and the Hcy (29.88 鹵2.25) mol/L of high transport group was lower than that of low transport group (31.90 鹵2.21) mol/L,. Conclusions: 1. The vascular endothelial dysfunction in PD patients was higher than that in the high transport group, and the vascular endothelial dysfunction was closely related to the level of CRP. It is suggested that improving the microinflammatory state of PD patients can improve the disturbance degree of vascular endothelial function. 2. Hyperlipidemia often exists in PD patients, while the Hcy level in patients with high peritoneal transport is generally lower than that in low transporters, which may be related to the clearance of Hcy by PD. It is important to control vascular endothelial dysfunction and microinflammation in patients with PD, especially in patients with high peritoneal transport.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R692.5
本文編號(hào)：2203319
[Abstract]:Aim: to evaluate the endothelial function of brachial artery by using FMD and (CRP) as the index of microinflammation, and to observe the effects of different peritoneal transport characteristics on endothelial function and CRP,Hcy. To provide clinical basis for evaluating cardiovascular events. Methods: from January 2015 to December 2016, 70 patients with continuous ambulatory peritoneal dialysis (continuous ambulatory peritoneal dialysis,CAPD) in the Department of Renal Medicine, first Hospital of Shanxi Medical University, were divided into two groups according to peritoneal equilibrium (PET) test: high transport group and low transport group. The plasma hypersensitive CRP and homocysteine (Hcy), were measured respectively. The serum creatinine, (Scr), blood urea, (BUN), serum albumin, (ALB), (Ca), serum phosphorus, (P), parathyroid hormone (iPTH) were detected. The vascular endothelial function was evaluated by brachial artery vasodilation (FMD), and the effects of different peritoneal transport characteristics on vascular endothelial function and CRP,Hcy were analyzed. SPSS 19.0 software package was used for statistical analysis. The result is 1: 1. There was no significant difference in gender, age and BMI (BMI), dialysis age between the two groups (P0.05). There was no significant difference in PTH,BUN and Scr between the two groups (P0.05). Compared with the low transport group, the ALB in the high transport group was significantly lower than that in the low transport group (P0.01). 2. There was no significant difference in primary disease between the two groups (P0.05). 3. The FMD value of high transport group (3.96 鹵1.11)% was lower than that of low transport group (6.05 鹵0.95)% (P0.01), the median CRP level of high transport group (3.88) mg/L was higher than that of low transport group (2.82) mg/L (P0.05), and the Hcy (29.88 鹵2.25) mol/L of high transport group was lower than that of low transport group (31.90 鹵2.21) mol/L,. Conclusions: 1. The vascular endothelial dysfunction in PD patients was higher than that in the high transport group, and the vascular endothelial dysfunction was closely related to the level of CRP. It is suggested that improving the microinflammatory state of PD patients can improve the disturbance degree of vascular endothelial function. 2. Hyperlipidemia often exists in PD patients, while the Hcy level in patients with high peritoneal transport is generally lower than that in low transporters, which may be related to the clearance of Hcy by PD. It is important to control vascular endothelial dysfunction and microinflammation in patients with PD, especially in patients with high peritoneal transport.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R692.5
【參考文獻(xiàn)】
相關(guān)期刊論文 前3條
1 劉俊偉;鄧愛(ài)民;宋丹丹;李紅梅;郭燕燕;;糖尿病腎病腹膜透析血管內(nèi)皮功能變化及內(nèi)皮功能不全的相關(guān)因素探討[J];現(xiàn)代生物醫(yī)學(xué)進(jìn)展;2013年27期
2 張霞;金惠敏;;慢性腎臟病與血管內(nèi)皮細(xì)胞功能的研究進(jìn)展[J];上海交通大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2012年04期
3 肖月;隋賓艷;趙琨;;我國(guó)終末期腎病現(xiàn)狀及透析技術(shù)的應(yīng)用、費(fèi)用及支付情況分析[J];中國(guó)衛(wèi)生政策研究;2011年05期
，本文編號(hào)：2203319
本文鏈接：http://sikaile.net/linchuangyixuelunwen/2203319.html
最近更新
教材專(zhuān)著
