可溶性细胞间黏附分子-1 和可溶性血管细胞黏附分子水平升高可预测血液透析患者外周动脉疾病。

Higher serum levels of soluble intracellular cell adhesion molecule-1 and soluble vascular cell adhesion molecule predict peripheral artery disease in haemodialysis patients.

机构信息

Institute of Medicine, Chung Shun Medical University, Department of Nephrology, Taichung Veterans General Hospital, Taichung, Taiwan.

出版信息

Nephrology (Carlton). 2012 Nov;17(8):718-24. doi: 10.1111/j.1440-1797.2012.01654.x.

DOI:10.1111/j.1440-1797.2012.01654.x

PMID:22905988

Abstract

AIM

Serum levels of soluble intracellular cell adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM) and monocyte chemotactic protein 1 (MCP-1), are elevated in patients with peripheral artery disease (PAD). However, the levels of these cell adhesion molecules in patients undergoing haemodialysis (HD) are unclear.

METHOD

A total of 112 HD patients were included and PAD was diagnosed using the ankle-brachial index and Doppler ultrasound. Serum levels of sICAM-1, sVCAM-1 and MCP-1 were assayed using enzyme linked immunosorbent assay.

RESULTS

Out of 106 HD patients, 31 (27.7%) were diagnosed with PAD. After adjusting for risk factors, higher serum levels of sVCAM-1 and sICAM-1 were associated with PAD in HD patients, with an odds ratio of 5.3 (95% CI 3.3-65.5) and 2.7 (95% CI 1.2-21.8) respectively. Using sVCAM-1 and sICAM-1 for diagnosis of PAD in HD patients, sVCAM-1 had a sensitivity of 72.4% and specificity of 62.3% for sVCAM-1 and sICAM-1 had a sensitivity of 89.3% and a specificity of 40%. MCP-1 was not associated with PAD in HD patients. In addition, the fistula of HD patients with PAD had a lower A-V access flow.

CONCLUSION

sVCAM-1 and sICAM-1 was associated with higher risk of PAD in HD patients. Moreover, HD patients with PAD had a lower blood flow and lower A-V access flow. Our results showed that sVCAM-1 and sICAM-1 may be used as screening markers for PAD in HD patients.

摘要

目的

可溶性细胞间黏附分子-1（sICAM-1）、可溶性血管细胞黏附分子-1（sVCAM-1）和单核细胞趋化蛋白 1（MCP-1）的血清水平在周围动脉疾病（PAD）患者中升高。然而，接受血液透析（HD）的患者这些细胞黏附分子的水平尚不清楚。

方法

共纳入 112 例 HD 患者，通过踝肱指数和多普勒超声诊断 PAD。采用酶联免疫吸附法测定 sICAM-1、sVCAM-1 和 MCP-1 的血清水平。

结果

在 106 例 HD 患者中，31 例（27.7%）诊断为 PAD。调整危险因素后，HD 患者血清 sVCAM-1 和 sICAM-1 水平与 PAD 相关，比值比分别为 5.3（95%可信区间 3.3-65.5）和 2.7（95%可信区间 1.2-21.8）。使用 sVCAM-1 和 sICAM-1 诊断 HD 患者 PAD，sVCAM-1 的敏感性为 72.4%，特异性为 62.3%；sICAM-1 的敏感性为 89.3%，特异性为 40%。MCP-1 与 HD 患者 PAD 无关。此外，PAD 的 HD 患者瘘管的 A-V 通路流量较低。