维持性血液透析患者嗜酸性粒细胞水平与颈动脉粥样硬化的关系

doi:10.3969/j.issn.1004-583X.2021.01.009

摘要/Abstract

摘要：

目的探讨维持性血液透析(MHD)患者嗜酸性粒细胞(EOS)水平与颈动脉粥样硬化的关系。方法选择临床资料完整的MHD患者151例,根据颈动脉超声分为对照组和硬化组96例,比较两组EOS、白细胞(WBC)、血红蛋白(HB)、血小板(PLT)、白蛋白(ALB)、血清铁蛋白(SF)、全段甲状旁腺激素(iPTH)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、小而低密度脂蛋白(sdLDL)、脂蛋白a(Lpa)以及微炎症状态检出率;再根据EOS计数的四分位数分为低、中、高3组,比较3组间的颈动脉硬化及微炎症状态的检出率,分析EOS水平与颈动脉硬化的关系。分析颈动脉内中膜厚度(IMT)与EOS计数的相关性。进一步观察EOS在MHD患者颈动脉粥样硬化中的作用。结果 151例患者中,检出颈动脉硬化96例(64%),与对照组相比,硬化组伴微炎症状态的人数较多,EOS、 TC、LDL-C、sdLDL水平较高(P<0.05);不同EOS分组间的颈动脉粥样硬化检出率及微炎症检出率比较差异有统计学意义(P<0.05);颈动脉IMT与EOS、TC、LDL-C呈正相关。TC、LDL-C是MHD患者发生颈动脉硬化的独立影响因素。结论 EOS增多是MHD患者颈动脉粥样硬化的相关因素,EOS水平较高的MHD患者更容易出现颈动脉硬化。

关键词: 肾透析, 嗜酸性粒细胞, 颈动脉粥样硬化

Abstract:

Objective To investigate the relationship between eosinophil (EOS) level and carotid atherosclerosis in maintenance hemodialysis (MHD) patients. Methods 151 MHD patients with complete clinical data in our hospital were selected and divided into control group and hardening group 96 cases according to carotid ultrasound. Comparison of two groups included high sensitivity C-reactive protein (hs-CRP), eosinophil (EOS), white blood cell (WBC), hemoglobin (HB), platelet (PLT), albumin (ALB), serum ferritin (SF), intact parathyroid hormone (iPTH), total cholesterol (TC), low density lipoprotein (LDL-C), triglyceride (TG), high-density lipoprotein (HDL-C), small and low-density lipoprotein (sdLDL), lipoprotein a (Lpa). The patients were divided into the lower quartile group, the middle quartile group, and the upper quartile group according to the quartiles of EOS. The detection rates of carotid atherosclerosis and micro-inflammation were compared among the three groups, and the relationship between eosinophil level and carotid atherosclerosis was analyzed.The correlation between carotid intima-media thickness (IMT) and EOS count was analyzed. Observation was further performed for the role of EOS in carotid atherosclerosis in MHD patients.Results Among 151 patients, 96 patients (64%) had carotid atherosclerosis. The number of patients with microinflammation in sclerotic group was more than that in control group, and TC, LDL-C, sdLDL levels were higher in sclerotic group(P<0.05); There were significant differences in the detection rate of carotid atherosclerosis and microinflammation among different EOS groups (P<0.05); IMT was positively correlated with EOS, TC, LDL-C.TC and LDL-C are independent factors of cervical arteriosclerosis in MHD patients. Conclusion Eosinophilia is a related factor of carotid atherosclerosis in MHD(maintenance hemodialysis) patients, and MHD patients with higher eosinophilia level are more likely to develop carotid atherosclerosis.

Key words: renal dialysis, eosinophils, carotid atherosclerosis

中图分类号:

R459.5

尚启航, 陈华茜. 维持性血液透析患者嗜酸性粒细胞水平与颈动脉粥样硬化的关系[J]. 临床荟萃, 2021, 36(1): 44-48.

Shang Qihang, Chen Huaqian. Relationship between eosinophil levels and carotid atherosclerosis in maintenance hemodialysis patients[J]. Clinical Focus, 2021, 36(1): 44-48.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.01.009

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I1/44

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参考文献 25

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组别	例数	EOS (×10⁹/L)	WBC (×10⁹/L)	HB (g/L)	PLT (×10⁹/L)	ALB (g/L)	SF (μg/L)	iPTH (pg/ml)
对照组	55	0.16±0.13	6.70±2.15	106.41±21.36	167.49±62.29	37.90±4.59	389.50(193.10,602.30)	201.20(102.60,286.80)
硬化组	96	0.30±0.39	6.30±2.29	106.93±18.72	173.34±66.52	38.84±5.59	370.05(157.80,716.95)	182.40(99.45,314.15)
t/Z值		-5.019	0.992	0.031	-0.306	-1.011	-0.337	0.609
P值		0.028	0.323	0.975	0.760	0.314	0.737	0.544
组别	例数	TC (mmol/L)	TG (mmol/L)	LDL-C (mmol/L)	HDL-C (mmol/L)	sdLDL (mmol/L)	Lpa (mg/L)	微炎症状态(例)
对照组	55	2.99±0.81	1.50±1.33	1.42±0.65	0.85(0.65,1.02)	0.30(0.19,0.49)	161.00(90.00,239.00)	15
硬化组	96	4.17±1.20	1.49±0.87	2.37±0.94	0.91(0.72,1.10)	0.42(0.30,0.78)	171.00(81.00,288.50)	39
t/χ²/Z值		-6.230	0.083	-6.346	-0.118	-2.208	-0.258	4.505
P值		0.000	0.787	0.000	0.329	0.029	0.421	0.034

组别	例数	EOS (×10⁹/L)	WBC (×10⁹/L)	HB (g/L)	PLT (×10⁹/L)	ALB (g/L)	SF (μg/L)	iPTH (pg/ml)
对照组	55	0.16±0.13	6.70±2.15	106.41±21.36	167.49±62.29	37.90±4.59	389.50(193.10,602.30)	201.20(102.60,286.80)
硬化组	96	0.30±0.39	6.30±2.29	106.93±18.72	173.34±66.52	38.84±5.59	370.05(157.80,716.95)	182.40(99.45,314.15)
t/Z值		-5.019	0.992	0.031	-0.306	-1.011	-0.337	0.609
P值		0.028	0.323	0.975	0.760	0.314	0.737	0.544
组别	例数	TC (mmol/L)	TG (mmol/L)	LDL-C (mmol/L)	HDL-C (mmol/L)	sdLDL (mmol/L)	Lpa (mg/L)	微炎症状态(例)
对照组	55	2.99±0.81	1.50±1.33	1.42±0.65	0.85(0.65,1.02)	0.30(0.19,0.49)	161.00(90.00,239.00)	15
硬化组	96	4.17±1.20	1.49±0.87	2.37±0.94	0.91(0.72,1.10)	0.42(0.30,0.78)	171.00(81.00,288.50)	39
t/χ²/Z值		-6.230	0.083	-6.346	-0.118	-2.208	-0.258	4.505
P值		0.000	0.787	0.000	0.329	0.029	0.421	0.034

EOS分组	例数	颈动脉粥样硬化	微炎症状态
低	44	21(47.7)	10(22.7)
中	69	42(60.8)	23(33.3)
高	38	29(76.3)	20(52.6)
χ²值		7.001	7.103
P值		0.030	0.029

EOS分组	例数	颈动脉粥样硬化	微炎症状态
低	44	21(47.7)	10(22.7)
中	69	42(60.8)	23(33.3)
高	38	29(76.3)	20(52.6)
χ²值		7.001	7.103
P值		0.030	0.029

指标	IMT
指标	r值	P值
EOS	0.212	0.009
WBC	0.002	0.976
PLT	0.060	0.462
HB	-0.007	0.927
ALB	0.063	0.439
iPTH	-0.070	0.414
SF	0.014	0.872
TC	0.320	0.000
TG	0.143	0.080
LDL-C	0.310	0.000
HDL-C	0.069	0.402
dsLDL	0.171	0.052
Lpa	0.035	0.710