不同支气管哮喘变异的肾小球滤过率和红细胞沉降率

V. N. Mineev, T. Vasilieva, I. Nesterovich, T. M. Lalaeva
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引用次数: 0

摘要

背景。以前,我们假设支气管哮喘(BA)和慢性肾脏疾病(CKD)的共同发病机制。鉴于肾小球滤过率和红细胞沉降率直接取决于血液的流变学特性,比较这两个重要特征在不同类型支气管哮喘中的作用是有意义的。同时,我们认为红细胞沉降率(ESR)不仅是全身性炎症的一个因素,也是红细胞聚集和血液流变学的一个模型。目的:比较不同类型BA患者肾小球滤过率和红细胞沉降率的变化。患者和方法。对215例不同BA变异的BA患者进行了检查。采用CKD-EPI计算肾小球滤过率(eGFR)。采用Panchenkov法测定红细胞沉降率(ESR)。采用积分eGFR/ESR指数作为每位患者eGFR和ESR值的比值。结果。与变应性BA相比,非变应性和激素依赖性BA的肾小球滤过率显著降低,ESR值显著升高。在同一组患者中,eGFR/ESR指数显著下降。因子分析显示,BA非过敏性变异的特征因子1在eGFR/ESR指数中负因子负荷非常高,FEV1负因子负荷也很高。因子2反映了BA变应性变异体中内皮功能障碍的特征,BA变应性变异体的eGFR/ESR指数成分在该因子中几乎没有因子负荷。因子3反映特应性状态的表现,因子负荷为正,包括eGFR/ESR指数的一个组成部分。结论。所获得的数据表明,支气管哮喘CKD的发展主要取决于疾病的变异。与疾病的变应性变异相比,非变应性和激素依赖性BA变异的eGFR/ ESR指数下降,表明血液微流变学特性参与了这两种疾病变异的CKD发展。相反,在BA的变应性变异中,在这些条件下CKD的发展可以受到抑制。
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Glomerular fi ltration rate and erythrocyte sedimentation rate in various bronchial asthma variants
BACKGROUND. Previously, we postulated the common pathogenetic mechanisms in bronchial asthma (BA) and chronic kidney disease (CKD). Given that both the glomerular filtration rate and the erythrocyte sedimentation rate directly depend on the rheological properties of the blood, it was of interest to compare these two important characteristics in different types of bronchial asthma. At the same time, we considered the erythrocyte sedimentation rate (ESR) not only as a factor in systemic inflammation, but also as a model of erythrocyte aggregation and hemorheology. THE AIM: to compare the level of glomerular filtration rate and erythrocyte sedimentation rate in different types of BA. PATIENTS AND METHODS. 215 BA patients with various BA variants were examined. The glomerular filtration rate (eGFR) was calculated using CKD-EPI. Erythrocyte sedimentation rate (ESR) was determined by the Panchenkov method. The integral eGFR/ESR index was used as the ratio of eGFR and ESR values in each individual patient. RESULTS. The glomerular filtration rate is significantly reduced, and the ESR values are significantly higher in non-allergic and hormone-dependent BA compared with the allergic variant of the disease. In the same groups of patients, a significant decrease in the eGFR/ESR index was revealed. Factor analysis revealed that Factor 1, which characterizes the non-allergic variant of BA, had the component of the eGFR/ESR index with a very high negative factor load along with a high negative factor load of the FEV1 component. Factor 2 reflects the features of endothelial dysfunction in the allergic variant of BA, the allergic variant of BA, and the component of the eGFR/ESR index has practically no factor load in this factor. Factor 3, reflecting the manifestations of an atopic state, with a positive factor load, includes a component of the eGFR/ESR index. CONCLUSION. The data obtained suggest that the development of CKD in bronchial asthma depends primarily on the variant of the disease. The decrease in the eGFR/ ESR index in non-allergic and hormone-dependent variants of BA compared with the allergic variant of the disease indicates the involvement of blood microrheological properties to the development of CKD in these two variants of the disease. On the contrary, in the allergic variant of BA, the development of CKD under these conditions can be restrained.
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