维持性血液透析患者血浆P-选择素及von Willebrand因子的变化

目的　研究尿毒症维持性血液透析 (MHD)患者血浆P 选择素及vonWillebrand因子 (vWF)的变化 ,并探讨其临床意义。方法　应用双抗体夹心酶联免疫吸附 (ELISA)法测定 68例MHD患者 (MHD组 )和 2 0例健康对照者 (对照组 )P 选择素、vWF含量 ,同时作颈动脉超声检测患者动脉粥样硬化情况。结果　 ( 1)MHD组P 选择素、vWF水平显著高于对照组(均P <0 0 1) ,MHD组中有颈动脉粥样硬化者P 选择素、vWF水平显著高于无颈动脉粥样硬化者 (P <0 0 5 ,P <0 0 1)。( 2 )MHD组vWF含量与甘油三酯水平呈正相关 (r=0 45 31,P <0 0 5 )。结论　MHD患者存在明显的血管内皮功能损害和血小板活化 ;P 选择素、vWF参与了MHD患者动脉粥样硬化的发生、发展过程 ;P 选择素、vWF可作为反映MHD患者内皮功能损害和血小板活化的生化标志物

Changes of P-selectin and von Willebrand factor in uremic patients with maintenance hemodialysis

Objective To investigate the changes of plasma levels of P-selectin and von Willebrand factor(vWF) in uremic patients with maintenance hemodialysis(MHD).Methods The levels of plasma P-selectin and vWF were measured by enzyme-linked immuno-sorbent assay(ELISA)in 68 MHD patients (MHD group) and 20 healthy subjects(control group).The carotid atherosclerosis of MHD patients was evaluated with B-mode carotid ultrasonography.Results (1)The levels of plasma P-selectin and vWF in MHD group were significantly higher than those in control group (all P<0.01),the levels of plasma P-selectin and vWF of MHD patients with carotid atherosclerosis were significantly higher than those in MHD patients without carotid atherosclerosis(P<0.05,P<0.01,respectively).(2)Plasma levels of vWF in MHD group were positively correlative with serum levels of hypertriglyceridemia ( r=0.453?1,P<0.05).Conclusions The results suggest that there is obvious endothelial dysfunction and platelet activation in uremic patients with MHD,P-selectin and vWF participate in the occurrence and development of atherosclerosis in MHD patients.P-selectin and vWF are valuable markers reflecting endothelial dysfunction and platelet activation in uremic patients with MHD.