维持性血液透析患者微炎症与脂蛋白（α）及动脉粥样硬化的关系

目的探讨尿毒症维持性血液透析（maintained hemodialysis,MHD）患者微炎症状态与脂质代谢紊乱以及动脉粥样硬化之间的相互关系。方法 68例MHD（MHD组）患者根据血清超敏C反应蛋白（high sensitivity c-re-active protein,hs-CRP）水平分为2组：hs-CRP增高组49例和hs-CRP正常组19例。根据颈动脉彩色多谱勒超声提示双侧颈动脉有无粥样斑块分为2组：合并颈动脉斑块组33例和未合并颈动脉斑块组35例。另选取30例健康体检者作为正常对照组。检测各组血清hs-CRP及脂蛋白（α）lipoprotein（α）,LP（α）]水平。结果 MHD组患者血清hs-CRP（5.23±3.07）mg.L-1水平较正常对照组（2.19±0.98）mg.L-1增高（P〈0.05）。MHD组患者血清LP（α）（293.40±192.58）mg.L-1水平较正常对照组（182.48±52.72）mg.L-1增高（P〈0.05）,hs-CRP增高组患者血清LP（α）（341.22±212.18）mg.L-1水平较hs-CRP正常组（236.45±128.20）mg.L-1增高（P〈0.05）。合并颈动脉斑块组患者血清hs-CRP、LP（α）分别为（6.98±3.22）mg.L-1、（363.07±208.77）mg.L-1,较未合并颈动脉斑块组（4.02±2.43）mg.L-1（、231.26±103.15）mg.L-1增高（P〈0.05）。相关性分析结果显示,MHD组患者血清hs-CRP水平与LP（α）水平呈正相关（r=0.51,P〈0.05）。结论 MHD患者普遍存在微炎症状态及Lp（α）代谢紊乱,且二者密切相关。同时,增高的hs-CRP及LP（α）与颈动脉粥样斑块的形成可能相关。

Relation between Microinflammatory and Lipoprotein（α） in Maintained Hemodialysis Patients with Atherosclerosis

Objective To study the relationships between microinflammatory state,disturbance of lipid metabolism and atherosclerosis in maintained hemodialysis（MHD） patients.Methods Sixty-eight cases of MHD（MHD group） patients were divided into 2 groups：high sensitivity c-reactive protein（hs-CRP） group（n=49） and normal hs-CRP group（n=19） according to serum hs-CRP level,respectively.In addition,those cases were divided into 2 groups：concurrence carotid artery plaque group（n=33） and non-carotid artery plaque group（n=35） according to the bilateral carotid artery color doppler ultrasound.As compared,30 healthy persons were sorted into normal control group.The levels of serum hs-CRP and lipoprotein（α） were detected in MHD and normal control groups.Results The levels of serum hs-CRP（5.23±3.07）mg·L-1 vs（2.19±0.98）mg·L-1,P0.05] and LP（α）（293.40±192.58） mg·L-1 vs（182.48±52.72）mg·L-1,P0.05] in MHD group were higher than those in normal control group;The levels of LP（α） in hs-CRP increased group were significantly higher than hs-CRP normal group：LP（α） （341.22±212.18） mg·L-1 vs（236.45±128.20） mg·L-1,P0.05].The levels of serum hs-CRP,LP（α） in carotid artery plaque group were significantly higher than non-carotid artery plaque group：hs-CRP（6.98±3.22）mg·L-1 vs（4.02±2.43） mg·L-1,P0.05] and LP（α） （363.07±208.77） mg·L-1 vs（231.26±103.15） mg·L-1,P0.05].Pearson correlation analysis results display：MHD group in patients of demonstrated a positively correlation between serum levels of hs-CRP and LP（α）（r=0.51,P0.05）.Conclusion The microinflammatory status and disturbance of LP（α） metabolism are extensively existed in MHD patients and closely related.Therefore,the higher levels of hs-CRP and the LP（α） might correlate with the formation of plaques in carotid artery.