慢性肾脏病患者血清可溶性细胞间粘附分子1与颈动脉粥样硬化的关系

目的研究慢性肾脏病（chronic kidney disease,CKD）患者血清可溶性细胞间粘附分子1（sICAM-1）的水平与颈动脉粥样硬化之间的关系,同时观察sICAM-1与各生化指标之间的关系。方法 64例CKD患者为CKD组,20例健康体检者为对照组。根据高频B超检测将CKD组分为A组（伴发颈动脉粥样硬化）、B组（不伴发颈动脉粥样硬化）2个亚组,记录颈动脉中层内膜厚度（ITM）;并记录患者的其他生化及免疫指标;采用SPSS17.0软件进行所有数据的统计分析。结果 CKD组患者sICAM-1水平明显高于对照组,分别为（432.48±175.42）ng/ml、（286.47±90.11）ng/ml,P〈0.01。颈动脉IMT值明显升高,同时血肌酐（Scr）、尿素氮（BUN）、甲状旁腺素（PTH）、甘油三酯（TG）也明显增高,红细胞压积（Hct）、钙（Ca）、白蛋白（Alb）、肾小球滤过率（GFR）明显降低。与不伴发颈动脉粥样硬化组相比,伴发颈动脉粥样硬化组sICAM-1、颈动脉IMT、尿酸（UA）、血磷（P）、总胆固醇（CH）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、超敏C反应蛋白（hs-CRP）、空腹血糖（FPG）差异有统计学意义（P〈0.05）。单因素相关分析结果示,CKD患者sICAM-1与颈动脉IMT（r=0.728,P〈0.01）、hs-CRP（r=0.689,P〈0.01）显著正相关。结论 CKD患者血清sICAM-1明显升高,血清sICAM-1与颈动脉IMT和hs-CRP正相关,并可能与CKD患者是否伴发动脉粥样硬化有关。

The relationship between serum soluble intercellular adhesion molecule-1 and carotid atherosclerosis in chronic kidney disease patients

Objective To investigate the relationship between serum soluble intercellular molecule-1（sICAM-1） and carotid atherosclerosis in chronic kidney disease （CKD） patients,meanwhile study the relationship between sICAM-1 and other biochemical and immune indicators.Methods 64 CKD patients （CKD group） and 20 healthy volunteers （control group） were studied.According to the result of high-resolution B-mode ultrasonograph the CKD patients were divided into two sub-group：CKD with carotid atherosclerosis（group A）,CKD without carotid atherosclerosis（group B）.The carotid IMT,biochemical and immune characteristics were collected;with SPSS17.0 software for all statistical analysis of date.Results Compared with control group,the sICAM-1 of CKD group was significantly higher（432.48±175.42）ng/ml vs（286.47±90.11）ng/ml,P0.01],the IMT,Scr,BUN,PTH,TG were also higher,the Hct,Ca,Alb,GFR were lower.The differences of sICAM-1,carotid IMT,UA,P,CH,LDL-C,hs-CRP and FPG between group A and group B were significant（P0.05）.The result of One-Way ANOVA suggested that there were significant positive correlations between sICAM-1 and carotid IMT（r=0.728,P0.01）,hs-CRP（r=0.689,P0.01）.Conclusion sICAM-1 significantly increase in CKD patients.The significant positive correlations between sICAM-1 and IMT,hs-CRP may associate with atherosclerosis in CKD.