全身性炎症因素对5D期慢性肾病患者心血管钙化征象检测风险的影响

A. Mambetova, M. H. Hutueva, I. K. Thabisimova
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引用次数: 0

摘要

背景。慢性肾脏疾病(CKD)是影响世界人口死亡风险的常见病理。主动脉和心脏结构(瓣膜、冠状动脉)的钙化是心血管并发症的危险因素。细胞因子、整合素促炎指标、急性期蛋白等炎症因子对膜外钙化风险的影响是有希望的。目的:研究细胞因子、综合促炎指数、急性期蛋白等炎症因子对骨外钙化风险的影响。患者和方法。对85例ckd5d患者进行了一项一期队列研究,患者接受了程序性血液透析治疗。一般临床检查按方案进行。采用免疫涡轮比色法测定血c反应蛋白(CRP)水平。使用CRP和血浆白蛋白浓度计算全身性炎症的格拉斯哥预后评分(GPS)风险指数。采用酶免疫法检测白细胞介素-6 (IL-6)、白细胞介素-3 (IL-3)水平。计算血白细胞移位指数(BLI)。超声心动图采用多普勒模式。记录心脏瓣膜钙化(CAC)的存在,并评估其严重程度。为了评估腹主动脉钙化程度,在左侧投影处进行了腹部x线摄影。采用L.I. Kauppilla钙化量表评估主动脉钙化表现的严重程度。采用STATISTICA 12.6进行统计分析。工具包(StatSoft,美国)。结果。全身性炎症因子对心血管钙化的严重程度有负面影响。GPS值的增加与CAC和CSA的严重程度相关。在考虑IL-3和IL-6值的钙化严重程度分析中,也显示这些促炎细胞因子的高水平与主动脉前壁钙化和L3水平主动脉钙化的严重表现有关。在分析中纳入ISLC对主动脉壁钙化的严重程度没有影响,对心脏瓣膜钙化的强度也没有影响,尤其是主动脉瓣和二尖瓣。
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Systemic inflammation factors influence on the risk of detecting signs of cardiovascular calcification in a patient with stage 5D chronic kidney disease
   BACKGROUND. Chronic kidney disease (CKD) is a common pathology influencing mortality risk in the world population. Calcification of aorta and heart structures (valves, coronary arteries) is a risk factor for cardiovascular complications. The influence of cytokines, integrin proinflammatory indices, acute phase proteins and other inflammatory factors on the risk of extravasal calcification is promising.   THE AIM: to study the effect of cytokines, integrative proinflammatory indices, acute phase proteins and other inflammatory factors on the risk of extra-osseous calcification.   PATIENTS AND METHODS. A one-stage, cohort study of 85 patients with CKD 5D treated with programmed hemodialysis was conducted. General clinical examination was carried out according to the protocol. Blood levels of C-reactive protein (CRP) were determined by immunoturbodimetry. A Glasgow Prognostic Score (GPS) risk index for systemic inflammation was calculated using CRP and plasma albumin concentrations. Interleukin-6 (IL-6), interleukin-3 (IL-3) were assessed by enzyme immunoassay. Blood leukocyte shift index (BLI) was calculated. Echocardioscopy was performed using Doppler mode. The presence of cardiac valve calcification (CAC) was registered, its severity was assessed. To estimate the abdominal aortic calcification, the abdominal radiography was carried out in the left lateral projection. The severity of manifestations of aortic calcification was assessed using the L.I. Kauppilla Calcification Scale. Statistical analysis was performed using STATISTICA 12.6. toolkit (StatSoft, USA).   RESULTS. Systemic inflammatory factors negatively affected the severity of cardiovascular calcification. An increased GPS value was found to correlate with the severity of CAC and CSA. In the case of calcification severity analysis considering IL-3 and IL-6 values, it was also shown that high levels of these pro-inflammatory cytokines are associated with severe manifestations of anterior aortic wall calcification and aortic calcification at the L3 level. Inclusion of ISLC in the analysis had no effect on the severity of calcification of the aortic wall and no effect on the intensity of cardiac valve calcification in general, the aortic valve and the mitral valve in particular.
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