Stompor Tomasz, Rajzer Marek, Sułowicz Władysław, Dembińska-Kieć Aldona, Janda Katarzyna, Kawecka-Jaszcz Kalina, Wójcik Katarzyna, Tabor Barbara, Zdzienicka Anna, Janusz-Grzybowska Eva
Collegium Medicum Uniwersytetu Jagielloriskiego w Krakowie.
Pol Merkur Lekarski. 2006 Aug;21(122):111-4; discussion 115-6.
Chronic inflammation is a widely accepted pathophysiologic factor of development and progression of atherosclerosis. One of the most important consequences of atherosclerosis is accelerated arterial stiffness. The impact of chronic inflammation on arterial stiffness was not analyzed up to now in patients with end-stage renal disease treated with peritoneal dialysis (PD). The aim of the study was to evaluate the possible relationship between aortic pulse wave velocity (AoPWV), considered useful tool of aortic stiffness assessment and blood pressure parameters, anthropometric characteristics, pro-inflammatory cytokines and acute phase reactants in patients treated with PD. MATERIAL AND METHOSA: The study was performed in the group of 43 patients (19 F 24 M) with ESRD, in the mean age of 50.6 +/- 13.4 years and on dialysis for the mean period of 21.9 +/- 20.7 months. Pulse wave velocity was assessed using two pressure transducers placed on common carotid and femoral artery, connected with automatic processor. In all patients Tumor Necrosis Factor alpha (TNF alpha), interleukin 6 (IL-6), C- reactive protein and fibrinogen were assayed as 'markers of inflammation'. Blood pressure was also measured in the standardized conditions. Mean AoPWV equaled 10.7 +/- 2.1 m/s. Significant correlations were found between AoPWV, age, body weight and BMI. AoPWV was associated with systolic blood pressure, mean arterial pressure and pulse pressure.
Significant correlations between AoPWV and serum IL-6 were shown, whereas association with CRP was close to statistical significance (p= 0,053). Associations between AoPWV, age and systolic blood pressure were also confirmed by multiple regression analysis.
Chronic, uremia-dependent inflammation may be one of the factors influencing aortic stiffness in patients treated with PD.
慢性炎症是动脉粥样硬化发生和发展中被广泛认可的病理生理因素。动脉粥样硬化最重要的后果之一是动脉僵硬度加速增加。迄今为止,尚未对接受腹膜透析(PD)治疗的终末期肾病患者中慢性炎症对动脉僵硬度的影响进行分析。本研究的目的是评估在接受PD治疗的患者中,被视为评估主动脉僵硬度有用工具的主动脉脉搏波速度(AoPWV)与血压参数、人体测量特征、促炎细胞因子和急性期反应物之间的可能关系。
本研究在43例终末期肾病患者(19例女性,24例男性)中进行,平均年龄为50.6±13.4岁,平均透析时间为21.9±20.7个月。使用放置在颈总动脉和股动脉上的两个压力传感器与自动处理器相连来评估脉搏波速度。在所有患者中检测肿瘤坏死因子α(TNFα)、白细胞介素6(IL-6)、C反应蛋白和纤维蛋白原作为“炎症标志物”。还在标准化条件下测量血压。平均AoPWV等于10.7±2.1米/秒。发现AoPWV与年龄、体重和体重指数之间存在显著相关性。AoPWV与收缩压、平均动脉压和脉压相关。
显示AoPWV与血清IL-6之间存在显著相关性,而与CRP的相关性接近统计学意义(p = 0.053)。多元回归分析也证实了AoPWV、年龄和收缩压之间的相关性。
慢性、尿毒症相关炎症可能是影响接受PD治疗患者主动脉僵硬度的因素之一。