老年维持性血透患者标准化蛋白分解率与颈动脉内膜中层厚度的关系

目的 探讨老年维持性血液透析（MHD）患者标准化蛋白分解率（nPCR）与颈动脉内膜中层厚度（IMT）的关系。方法检测48例老年MHD患者一般临床指标及血清C-反应蛋白（CRP）水平，同时应用高分辨彩色B超测量患者颈动脉内膜中层厚度（IMT），按患者标准化蛋白分解率（nPCR）水平分为nPCR≥1．0组及nPCR〈1．0组，分析两组患者临床指标及颈动脉内膜中层厚度（IMT）。结果nPCR≥1．0组老年MHD患者血清白蛋白（AIb）、尿素氮（BUN）、血肌酐（Scr）显著高丁nPCR〈1．0组，CRP和IMT显著低于nPCR〈1．0组；nPCR与CRP、AIb、BUN、Scr、IMT显著相关（P〈0．01或0．05）。结论nPCR为反映老年MHD患者透析充分性和营养状况的有用指标，且与炎症状态、动脉粥样硬化及营养状况有关；炎症、营养不良、动脉硬化互为因果。

Relationship between carotid intra-media thickness and normalized protein catabolic rate in senile patients on maintenance hemodialysis

Objective To study the relationship between carotid intra -media thickness （IMT） and normalized protein catabolic rate of maintenance Hemodialysis （MHD） in senile patients. Methods The common clinical indexes and C- reactive protein （CRP） in 48 senile MHD patients were measured and the carotid intra-media thickness （IMT） of extracranial common carotid artery was examined by high-resolution B-mode ultrasonography. Based on the normalized protein catabolic rate （nPCR）, these patients were divided into two groups, i. e. nPCR≥ 1.0 group and nPCR〈 1.0 group. The common laboratory tests, CRP, nPCR of the two groups were compared. Results Compared with those in nPCR 〈 1.0 group, the levels of serum albumin （Alb）, blood urea nitrogen （BUN）, serum creatinine （Scr） were significantly higher and CRP and IMT were significantly lower in nPCR ≥ 1.0 group. There were significant relationships between nPCR and the levels of CRP, Alb, BUN, Scr and IMT, respectively （P〈0.01 or 0.05）. Conclusions nPCR is a helpful index to evaluate the adequacy of hemodialysis and nutritional conditions in senile MHD patients and is highly associated with inflammation, atherosclerosis, and nutritional status. Inflammation, malnutrition, and atherosclerosis are integrated.