本文選題：腎病 + 內(nèi)皮細胞��； 參考：《中國全科醫(yī)學》2017年12期

【摘要】：目的探討慢性腎臟病(CKD)未透析患者五聚素3(PTX3)與血管內(nèi)皮功能障礙的關系。方法選取2012年4月—2013年12月在首都醫(yī)科大學附屬北京朝陽醫(yī)院腎內(nèi)科住院或門診治療的符合納入標準的CKD患者70例,采用簡化MDRD公式計算估算腎小球濾過率(e GFR),并根據(jù)e GFR將患者分為CKD 1~3期組(A組,n=30)和CKD 4~5期組(B組,n=40)。另選取同期在首都醫(yī)科大學附屬北京朝陽醫(yī)院體檢中心體檢健康者30例為對照組。采用ELISA法檢測血清PTX3,采用外周動脈張力檢測技術檢測反應性充血指數(shù)(RHI)。收集3組一般資料[性別、年齡、糖尿病發(fā)生率、高血壓發(fā)生率、吸煙率、收縮壓(SBP)、舒張壓(DBP)、脈壓(PP)、平均動脈壓(MAP)、體質(zhì)指數(shù)(BMI)]、實驗室檢查指標[白細胞計數(shù)(WBC)、中性粒細胞分數(shù)(NE)、血紅蛋白(HGB)、清蛋白(ALB)、總膽固醇(TC)、三酰甘油(TG)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)、尿素氮(BUN)、血肌酐(Scr)、尿酸(UA)、血鈣、血磷、全段甲狀旁腺激素(PTH)]、炎性指標[超敏C反應蛋白(hs-CRP)、PTX3]、血管內(nèi)皮功能指標(內(nèi)皮素、RHI),并分析CKD患者PTX3與各指標的相關性。結(jié)果 A組SBP、MAP高于對照組(P0.05);B組SBP、PP、MAP高于對照組、A組,DBP高于對照組(P0.05)。A組NE、LDL-C、UA高于對照組,HGB、ALB低于對照組(P0.05);B組NE、BUN、Scr、血磷、PTH高于對照組、A組,HGB、血鈣低于對照組和A組,ALB低于對照組,LDL-C、UA高于對照組(P0.05)。A組PTX3高于對照組,RHI低于對照組(P0.05);B組hs-CRP、PTX3、內(nèi)皮素高于對照組、A組,RHI低于對照組、A組(P0.05)。Pearson相關性分析結(jié)果顯示,PTX3與WBC(r=0.300,P=0.046)、NE(r=0.422,P=0.004)、Scr(r=0.320,P=0.032)、hs-CRP(r=0.342,P=0.022)、內(nèi)皮素(r=0.307,P=0.036)呈正相關,與RHI(r=-0.374,P=0.011)呈負相關。結(jié)論 CKD患者PTX3與內(nèi)皮素呈正相關,與RHI呈負相關。與hs-CRP相比,PTX3對于預測CKD患者血管內(nèi)皮功能障礙可能是一個更好的指標。
[Abstract]:Objective to investigate the relationship between pentagglutinin 3 (PTX 3) and vascular endothelial dysfunction in patients with chronic kidney disease (CKD) without dialysis. Methods from April 2012 to December 2013, 70 patients with CKD who were hospitalized or outpatient treated in Department of Renal Medicine, Beijing Chaoyang Hospital affiliated to Capital Medical University, were selected. A simplified MDRD formula was used to calculate and estimate glomerular filtration rate (GFR). According to e GFR, patients were divided into three groups: group A (group A) and group B (group B). The patients were divided into two groups: group A (group A) and group B (group B). Another 30 healthy subjects were selected as control group in Beijing Chaoyang Hospital affiliated to Capital Medical University in the same period. The serum PTX3 was detected by ELISA and the reactive hyperemia index (RHI) by peripheral arterial tension test. Collect general data of 3 groups [sex, age, incidence of diabetes, incidence of hypertension, smoking rate, Systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), mean arterial pressure (map), body mass index (BMI)], laboratory tests [WBC count, neutrophil fraction (neo), hemoglobin HGBN, Albumin, total cholesterol (TC), triacylglycerol (TGN), high density lipoprotein gallbladder (HDL-C). High density lipoprotein cholesterol, low density lipoprotein cholesterol, urea nitrogen bun, creatinine creatinine, creatinine, uric acid UAA, serum calcium, Serum phosphorus, total parathyroid hormone (PTH)], inflammatory index [hypersensitive C-reactive protein (hs-CRP) PTX3], vascular endothelial function index (endothelin), and the correlation between PTX3 and various indexes in CKD patients were analyzed. Results the map of group A was higher than that of group B (P 0.05). The map of group A was higher than that of group A (P 0.05). Group A was higher than control group (P 0.05). Group A was lower than control group (P 0.05). The level of blood phosphorus PTH was higher than that of group A (HGBs), and the level of serum calcium was lower than that of control group (P < 0.05) and group A (P < 0.05). The level of serum calcium in group A was lower than that in group A and the level of ALB in group A was lower. The results of correlation analysis showed that the PTX3 of group A was higher than that of group A (P 0.05). The PTX3 of group A was higher than that of group B (P 0.05), and the level of endothelin was higher than that of group A (P 0.05). Pearson correlation analysis showed that there was a positive correlation between PTX3 and WBCr0.300P0.04Scrrrn 0.320P0.032hCRPr0.342P0. 0222P, et 0.307P0. 036. the results of correlation analysis showed that there was a positive correlation between PTX3 and WBCr0. 300P0. 004P0. 004Scrrn 0.320P0. 320P0. 32hCRPr0. 342P0. 0222P, endothelin 0. 307P0. 036. the results showed that there was a positive correlation between PTX3 and WBCr0. 300P0. 004P0. 004. There was a negative correlation with RHI ru-0.374 (P < 0. 011). Conclusion PTX3 is positively correlated with endothelin and negatively correlated with RHI in CKD patients. Compared with hs-CRP, PTX3 may be a better marker for predicting vascular endothelial dysfunction in patients with CKD.
【作者單位】： 首都醫(yī)科大學附屬北京朝陽醫(yī)院腎內(nèi)科;北京積水潭醫(yī)院腎內(nèi)科;首都醫(yī)科大學附屬北京朝陽醫(yī)院綜合科;
【分類號】：R692
，

本文編號：1856116