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维持性血液透析患者血清基质金属蛋白酶-10与动脉粥样硬化的关系

孙桂江   

  1. 天津医科大学第二医院血液净化科
  • 收稿日期:2012-09-25 修回日期:2013-03-05 出版日期:2013-08-15 发布日期:2013-08-15
  • 通讯作者: 孙桂江

The Association between Matrix Metalloproteinase-10 and Atherosclerosis in Maintenance Hemodialysis Patients

SUNGui-Jiang   

  • Received:2012-09-25 Revised:2013-03-05 Published:2013-08-15 Online:2013-08-15
  • Contact: SUNGui-Jiang

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摘要： 【摘要】 目的 探讨维持性血液透析患者血清基质金属蛋白酶（MMP）-10水平与动脉粥样硬化（AS）发生之间的关系。 方法 抽取30例门诊正常体检者为正常对照组，60例维持性血液透析患者为血液透析组，比较2组MMP-10水平；根据颈内动脉彩超结果将血液透析组分为AS组和非AS组，比较2组间 MMP-10、血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、尿酸、白蛋白（Alb）、C反应蛋白（CRP）、颈动脉内膜中层厚度（cIMT）、PROCAM评分及组织金属蛋白酶抑制物-1 等水平；分析血液透析患者MMP-10与其他指标的相关性。 结果 血液透析组 MMP-10水平（1 263.08±698.28） ng/L高于正常对照组（749.27±340.08） ng/L（P＜ 0.01），AS组MMP-10水平高于非AS组（[ 1 420.30±786.25）ng/L vs（971.10±355.18）ng/L，P＜ 0.05]。 血液透析组MMP-10与年龄、CRP、 cIMT及PROCAM评分呈正相关，与Alb水平呈负相关（r=-0.314）。 结论 维持性血液透析患者中 MMP-10水平升高，并与AS的发生有关。

关键词: 肾透析, 动脉粥样硬化, 颈动脉, 超声检查, 多普勒, 彩色, 基质金属蛋白酶10, 金属蛋白酶1 组织抑制剂

Abstract: Objective   To explore whether there is an association between matrix metalloproteinase-10 (MMP-10) and atherosclerosis in maintenance hemodialysis patients. Method   All individuals were sampled randomly from our hospital, 60 patients from the center of blood purification, 30 healthy subjects from medical examination center whose carotid intima media thickness (cIMT) are normal. All indexes are taken to comparison between 2 groups. We analysis the association between MMP-10 and other indexes in experiment group, and divide these patients into 4 groups accord to MMP-10 and take the number of patients with increased cIMT and plague to comparison between 4 groups. Besides, we also take increased cIMT and plague into Logistic stepwise regression analysis. Results    1)There is significant difference of systolic pressure, diastolic pressure, Glu, Alb, BUN, Cr, HDLc, MMP-10, TIMP-1, cIMT between two groups. 2) There is positive association between serum MMP-10 and age, hsCRP, cIMT, PROCAM, but a negative association between serum MMP-10 and Alb (P＜0.05). We don’t find significant correlation between MMP-10 and TIMP-1. cIMT is positively and significantly associated with age, PROCAM, MMP-10(P＜0.05). We don’t find any significant correlation between TIMP-1 and other items. 3) The patients with increased cIMT (χ2=8.938，P=0.030) and plague (χ2=8.782，P=0.032) are increased with a higher concentration. 4) Logistic stepwise regression analysis reveals the increased LDL-c/HDL-c may be a risk factor of the increased cIMT in maintenance hemodialysis patients.Overweight and increased cIMT may be risk factors of the plague(P＜0.05) in maintenance hemodialysis patients. Conclusion    MMP-10 is positively and significantly associated with cIMT and plague, but MMP-10 is not the risk factor of them.

Key words: Renal dialysis, Atherosclerosis, Carotid artery, Ultrasonography, Doppler, color, 金属蛋白酶1 组织抑制剂