终末期肾病腹膜透析患者血清鸢尾素水平与颈动脉粥样硬化及左心室肥厚相关性研究-东南大学学报医学版

终末期肾病腹膜透析患者血清鸢尾素水平与颈动脉粥样硬化及左心室肥厚相关性研究

单位：1. 海南医学院第一附属医院肾内科, 海南海口 570102;
2. 海南医学院第一附属医院心血管内科, 海南海口 570102

分类号：R541;R543.4;R692

出版年·卷·期（页码）：2019·38·第二期（318-322）

摘要：

目的：探讨终末期肾病腹膜透析患者血清鸢尾素水平与颈动脉粥样硬化及左心室肥厚相关性。方法：本院终末期肾病并行腹膜透析的患者118例为观察组，同期选择本院门诊健康体检者112例作为对照组，测定两组TC、TG、HDL-C、LDL-C、鸢尾素、LVMI、LVEF水平，分析血清鸢尾素水平与颈动脉粥样硬化及左心室肥厚相关性。结果：观察组收缩压、舒张压高于对照组，差异有统计学意义（t=15.352、12.455，P<0.05）；观察组鸢尾素水平明显高于对照组，差异有统计学意义（t=14.350，P<0.05）；观察组TC、TG、LDL-C水平高于对照组，HDL-C水平低于对照组，差异有统计学意义（t=12.452、13.092、14.012、15.813，P<0.05）；观察组IMT、LVMI水平高于对照组，LVEF水平低于对照组，差异有统计学意义（t=13.509、14.120、15.913，P<0.05）；鸢尾素与TC、TG、LDL-C、IMT、LVMI呈显著正相关，与HDL-C、LVEF呈显著负相关，差异有统计学意义（r=0.45、0.48、0.52、0.43、0.53、-0.42、-0.51，P<0.05）；鸢尾素、TG均为终末期肾病腹膜透析患者发生颈动脉粥样硬化左心室肥厚的危险因素（OR=4.20、5.47，P<0.05）。结论：终末期肾病腹膜透析患者血清鸢尾素水平升高，其与颈动脉粥样硬化及左心室肥厚程度密切相关；鸢尾素、TG均为终末期肾病腹膜透析患者发生颈动脉粥样硬化左心室肥厚的危险因素，鸢尾素可作为预测病情的重要指标。

Objective:To investigate the relationship between serum irisin level and carotid atherosclerosis and left ventricular hypertrophy in patients with end-stage renal disease peritoneal dialysis. Methods:A total of 118 patients with end-stage renal disease and peritoneal dialysis were enrolled as the observation group in the hospital. 112 patients who underwent physical examination in the outpatient department were selected as the control group. The levels of TC, TG, HDL-C, LDL-C, irisin, LVMI and LVEF were measured. The correlation between serum irisin levels and carotid atherosclerosis, left ventricular hypertrophy was analyzed. Results:The systolic blood pressure and diastolic blood pressure of the observation group were higher than those of the control group (t=15.352, 12.455, P<0.05). The level of irisin in the observation group was significantly higher than that in the control group (t=14.350, P<0.05); the levels of TC, TG and LDL-C in the observation group were higher than those in the control group, and the HDL-C level was lower than that in the control group, the differences were statistically significant (t=12.452, 13.092, 14.012, 15.813, P<0.05); The levels of IMT and LVMI in the observation group were higher than those in the control group, and the level of LVEF was lower than that in the control group. The differences were statistically significant (t=13.509, 14.120, 15.913, P<0.05). Irisin had significant positive correlation with TC, TG, LDL-C, IMT, LVMI, and had negative significant correlation with HDL-C and LVEF. The differences were statistically significant (r=0.45, 0.48, 0.52, 0.43, 0.53, -0.42, -0.51, P<0.05); irisin and TG were the risk factors for carotid atherosclerotic left ventricular hypertrophy in patients with end-stage renal disease peritoneal dialysis (OR=4.20, 5.47, P<0.05). Conclusion:The serum irisin level of patients with end-stage renal disease peritoneal dialysis is increased, which is closely related to carotid atherosclerosis and left ventricular hypertrophy. Irisin and TG are the risk factors of carotid atherosclerotic left ventricular hypertrophy in patients with end-stage renal disease peritoneal dialysis. Irisin can be used as an important indicator for predicting the condition.

参考文献：

[1] 牛宁宁,唐缨,赵静雯,等.终末期肾病患者左心房功能改变及与左心室功能的相关性研究[J].中国全科医学,2017,20(35):67-69.
[2] 范倩倩,马杰.调脂药在终末期肾脏病透析中的应用[J]. 中国药师,2017,20(9):1618-1622.
[3] 魏媛媛,祝小东,张莉,等.终末期肾脏病患者与成年健康个体免疫功能的比较[J].中国血液净化,2017,16(5):318-321.
[4] 卢振飞.2型糖尿病肾病患者肾小球滤过膜超微结构改变与肾功能及代谢指标的相关性研究[J].现代医学,2017,8(3):416-419.
[5] 苏敏,林坤河,周亚旭,等.湖北省贫困人口肿瘤和终末期肾病医疗费用及其影响因素分析[J].中华医院管理杂志,2017,33(3):178-181.
[6] 高豆青,单岩,张琳,等.终末期肾脏病患者与主要照顾者疾病不确定感的相关性研究[J].重庆医学,2017,46(8):1145-1148.
[7] 袁媛,周莉,袁怀红.血液透析或腹膜透析终末期肾病老年患者的生存预后及其影响因素研究[J].实用医院临床杂志,2017,14(6):264-266.
[8] MAZUR-BIALY A I.Irisin acts as a regulator of macrophages host defense[J].Life Sciences,2017,176(4):21-23.
[9] WANG H,ZhAO Y T,ZhANG S,et al.Irisin plays a pivotal role to protect the heart against ischemia and reperfusion injury[J].Journal of Cellular Physiology,2017,232(12):3775-3776.
[10] EFE T H,ACAR B,ERTEM A G,et al.Serum irisin level can predict the severity of coronary artery disease in patients with stable angina[J].Korean Circulation Journal,2017,47(1):44-49.
[11] WINN N C,GRUNEWALD Z I,LIU Y,et al.Plasma irisin modestly increases during moderate and high-intensity afternoon exercise in obese females[J].PLoS One,2017,12(1):690-691.
[12] 佟莉,帅宁安,吴春珠,等.血清鸢尾素水平与胰岛素抵抗的相关性研究[J].临床内科杂志,2017,6(9):616-618.
[13] 王明明,刘师伟,李欣.鸢尾素对糖脂代谢的作用及机制研究[J].中国药物与临床,2016,16(7):993-996.
[14] 贺强,漆正堂,丁树哲.骨骼肌的内分泌功能与运动代谢适应[J].中国运动医学杂志,2015,34(2):201-207.
[15] 卢俊颜,向光大,梅稳,等.鸢尾素改善载脂蛋白E基因敲除糖尿病小鼠动脉粥样硬化[J].中国循环杂志,2015,30(5):492-497.
[16] 李白洁,范志宏,丁明辉,等.血清鸢尾素与2型糖尿病颈动脉粥样硬化的相关研究[J].中国糖尿病杂志,2017,9(8):499-503.

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