脂联素及炎症因子与慢性肾衰竭伴发颈动脉粥样硬化的关系

目的 探讨脂联素及炎症因子与慢性肾衰竭(CRF)伴发颈动脉粥样硬化(CAS)的关系.方法 CAS 106例,其中CRF组64例、非CRF组42例,同时纳入健康对照组30例.采用酶联免疫吸附法测定血清脂联素、肿瘤坏死因子(TNF-α)水平,采用自动生化分析仪测定C反应蛋白(CRP)、血肌酐及尿素氮,多普勒超声心动图测量颈内动脉内膜-中层厚度(IMT).对一般指标、炎症因子、IMT与脂联素的相关性进行分析,并采用logistic回归分析CRF合并CAS的危险因素.结果 CRF组血清脂联素、TNF-α、CRP水平、IMT高于/厚于非CRF组(均P<0.05).CRF组和非CRF组脂联素水平与年龄、体重指数、肾小球滤过率、CRP、TNF-α、IMT均呈负相关,与收缩压、舒张压、血肌酐、尿素氮呈正相关(均P<0.05).Logistic回归分析显示CRP、TNF-α是CRF伴发CAS的独立危险因素.结论 脂联素、CRP、TNF-α与CRF患者CAS发生发展有密切联系;CRF患者血清脂联素水平升高可能是肾脏对微炎症状态做出的自我防御性反应.

Relationship of adiponectin and inflammatory factors with chronic renal failure complicated with carotid atherosclerosis

Objective To investigate the relationship of adiponectin and inflammatory factors with chronic renal failure ( CRF ) complicated with carotid atherosclerosis ( CAS ) .Methods A total of 106 cases with carotid atherosclerosis were enrolled , including 64 cases in CRF group and 42 cases in non CRF group ,with 30 subjects as healthy control group .Serum adiponectin and tumor necrosis factor alpha(TNF-α) levels were detected by enzyme-linked immunosorbent assay.C-reactive protein(CRP),serum creatinine(SCr),and blood urea nitrogen(BUN) were detected by automatic biochemistry analyzer .Intima-media thickness(IMT) of internal carotid artery was measured by Doppler echocardiography .Correlations of general indicators , inflammatory factors , and IMT with adiponectin were analyzed , Logistic regression analysis was used to analyze the risk factors of CRF complicated with carotid atherosclerosis .Results The levels of serum adiponectin,TNF-α,CRP and IMT in CRF group were higher than those in non CRF group (P<0.05).In both CRF group and non CRF group,the adiponectin level negatively correlated with age ,body mass index,glomerular filtration rate,CRP,TNF-α,and IMT(P<0.05), but positively correlated with systolic blood pressure ,diastolic blood pressure,SCr,and BUN(all P<0.05).The result of logistic regression analysis showed that both CRP and TNF-αwere independent risk factors for CRF complicated with carotid atherosclerosis .Conclusion Adiponectin,CRP,and TNF-αare closely related to the occurrence and development of carotid atherosclerosis in patients with CRF .The elevated serum adiponectin level in patients with CRF may be the self-defensive response of the kidneys to the microinflammatory state .