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目的探讨持续性非卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者血清全段甲状旁腺激素(intact parathyroid hormone,iPTH)水平、血浆白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平与左心室肥厚的关系。方法行CAPD患者114例,采用化学发光免疫夹心法检测血清iPTH水平,按iPTH水平分为>300ng/L组36例、150~300ng/L组28例、70~<150ng/L组24例和<70ng/L组26例。采用ELISA法检测4组血浆IL-6、TNF-α水平,应用彩色超声心动图检测左心室心肌重量指数(left ventricular mass index,LVMI)。结果 >300ng/L组左心室肥厚发生率(69.4%)明显高于150~300ng/L组(42.9%)和70~<150ng/L组(25.0%)(P<0.05),与<70ng/L组(53.8%)比较差异无统计学意义(P>0.05);<70ng/L组左心室肥厚发生率高于70~<150ng/L组(P<0.05),与150~300ng/L组比较差异无统计学意义(P>0.05);>300ng/L组和<70ng/L组血浆IL-6[(12.74±9.81)、(12.28±8.96)ng/L]、TNF-α[(18.59±11.85)、(17.38±10.24)ng/L]水平和LVMI[(151.62±38.49)、(125.27±41.62)g/m2]明显高于150~300ng/L组[(3.19±1.54)ng/L、(7.28±2.79)ng/L、(117.80±36.04)g/m2](P<0.01),>300ng/L组与<70ng/L组以上指标比较差异无统计学意义(P>0.05);iPTH与LVMI、IL-6、TNF-α呈正相关(r=0.507,P=0.019;r=0.364,P=0.030;r=0.297,P=0.041),LVMI与IL-6、TNF-α呈正相关(r=0.413,P=0.024;r=0.263,P=0.038)。结论 CAPD患者iPTH与左心室肥厚的发生、发展密切相关;iPTH水平过高或过低患者血浆IL-6、TNF-α水平均增高,IL-6、TNF-α可能参与iPTH引起左心室肥厚的发生。
Objective To investigate the changes of serum intact parathyroid hormone (iPTH) level, plasma interleukin-6 (IL-6), tumor size in patients with continuous ambulatory peritoneal dialysis (CAPD) Relationship between the level of tumor necrosis factor-α (TNF-α) and left ventricular hypertrophy. Methods One hundred and fourty-four patients with CAPD were enrolled in this study. Serum iPTH levels were measured by chemiluminescence immuno-sandwich method. Thirty iPTH levels were divided into three groups: 36 cases in> 300ng / L group, 28 cases in 150-300ng / L group, 24 cases in 70 ~ 150ng / <70ng / L group of 26 cases. Plasma IL-6 and TNF-α levels were measured by ELISA. Left ventricular mass index (LVMI) was measured by color echocardiography. Results The incidence of left ventricular hypertrophy in the group of> 300ng / L (69.4%) was significantly higher than that of the group of 150 ~ 300ng / L (42.9%) and 70 ~ <150ng / The incidence of left ventricular hypertrophy in 70ng / L group was higher than that in 70 ~ <150ng / L group (P <0.05), but not in L group (53.8%) (P> 0.05) (12.74 ± 9.81), (12.28 ± 8.96) ng / L], TNF-α [(18.59), P <0.05), and there was no significant difference between the two groups ± 11.85), (17.38 ± 10.24) ng / L] and LVMI [(151.62 ± 38.49), (125.27 ± 41.62) g / m2] were significantly higher than those in the 150-300ng / L, (7.28 ± 2.79) ng / L, (117.80 ± 36.04) g / m2] (P <0.01). There was no significant difference between the groups of> 300ng / L and <70ng / There was a positive correlation between LVTH, IL-6 and TNF-α in LVMI, IL-6 and TNF-α (r = 0.507, P = 0.019; r = 0.364, P = 0.030; r = 0.297, P = 0.041) (r = 0.413, P = 0.024; r = 0.263, P = 0.038). Conclusions iPTH is closely related to the occurrence and development of left ventricular hypertrophy in patients with CAPD. The levels of plasma IL-6 and TNF-α in patients with iPTH are higher or lower, while IL-6 and TNF-α may be involved in the pathogenesis of left ventricular hypertrophy occur.