慢性肾脏病5期非透析患者动脉粥样硬化危险因素分析

目的 探讨慢性肾脏病5期非透析患者发生颈动脉粥样硬化的危险因素.方法 选择慢性肾脏病5期非透析患者54例和健康对照者31名检测血肌酐、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、脂蛋白α、白蛋白、血清钙、血清磷、C反应蛋白、晚期氧化蛋白产物等指标,并进行颈动脉超声检查颈动脉内膜中层厚度和粥样斑块.分析影响颈动脉内膜中层厚度的危险因素.结果 两组患者晚期氧化蛋白产物、C反应蛋白比较差异有统计学意义(P＜0.01),且慢性肾脏病5期非透析患者中颈动脉内膜中层厚度明显增厚且动脉斑块发生率高(P＜0.01);多元线性回归分析显示年龄、收缩期血压、血清磷、脂蛋白α、氧化蛋白产物、C反应蛋白是颈动脉内膜中层厚度增厚的独立危险因素.结论 氧化应激、微炎症反应及高血压、高血脂、高血磷等复杂因素的相互作用可能在慢性肾脏病5期非透析患者加速冠状动脉粥样硬化的发生、发展中起重要作用.

Risk factors analysed for atherosclerosis in nodialytic patients with chronic kidney disease 5 stage

Objective To determine the risk facors for atherosclerosis in nodialytic patients with chronic kidney disease 5 stage. Methods The values were measured in both groups, experimental group ( n = 45 ) and control group ( n = 30), including serum creatinine ( Cr ), triglyceride (TG), total cholesterol (TC), low density lipoprotein-choleterol (LDL-C), high density lipoprotein-choleterol (HDL-C), lipoprotein Lp(a)], Calcium(Ca), phosphorus(Ph), C-reactive protein(CRP), Advanced oxidation protein products (AOPPs), etc. Patients in both group underwent carotid artery ultrasound to evaluate intima-media thickness (IMT) and carotid plaque. The risk factors for the carotid artery IMT were analysed in CKD 5 stage group.Result The values of CRP,AOPPs and IMT were significantly increased in CKD group compared with control group;The risk factors for the carotid artery IMT were age, SBP, Ph, Lp (a), AOPPs, CRP.Conclusion Complex factors interaction plays important roles for promoting atherosclerosis in nodialytic patients with chronic kidney disease 5 stage, including oxidative stress, microinflammatory status, hypertension, hyperlipaemia, etc.