Nagai Kei, Ueda Atsushi, Saito Chie, Zempo-Miyaki Asako, Yamagata Kunihiro
Department of Nephrology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan ; Comprehensive Human Sciences, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
Tsukuba University Hospital Hitachi Medical Education and Research Center, Jonan-cho 2-1-1, Hitachi, Ibaraki 317-0077, Japan.
Int J Nephrol. 2014;2014:297954. doi: 10.1155/2014/297954. Epub 2014 Dec 22.
Pentraxin 3 (PTX3), a multifunctional modulator of the innate immunoinflammatory response, is higher in patients undergoing hemodialysis than healthy control. Our study focused on annual change in PTX3 levels in patients with chronic hemodialysis, because regularly undergoing hemodialysis for many years modifies vascular inflammatory status. To demonstrate whether annual change in PTX3 is associated with vascular events, we measured blood levels of pentraxins (PTX3 and high-sensitivity C-reactive protein (hsCRP)) at baseline and in the next year in 76 hemodialysis patients and observed 20 patients with vascular access troubles during follow-up years. The annual decline in PTX3, but not hsCRP, is a significant risk of the incidence of vascular access trouble that is a critical and specific complication for hemodialysis patients (hazard ratio; 0.732 per +1 ng/mL/year in PTX3, (*) P = 0.039). This study is the first to focus on the annual change of pentraxins in a hemodialysis cohort.
五聚体蛋白3（PTX3）是先天性免疫炎症反应的多功能调节剂，接受血液透析的患者体内的PTX3水平高于健康对照者。我们的研究聚焦于慢性血液透析患者PTX3水平的年度变化，因为多年定期进行血液透析会改变血管炎症状态。为了证明PTX3的年度变化是否与血管事件相关，我们在76例血液透析患者的基线期和次年测量了五聚体蛋白（PTX3和高敏C反应蛋白（hsCRP））的血药浓度，并在随访期间观察了20例出现血管通路问题的患者。PTX3的年度下降而非hsCRP的年度下降，是血管通路问题发生的显著风险因素，血管通路问题是血液透析患者的一种关键且特殊的并发症（风险比；PTX3每增加1 ng/mL/年为0.732，（*）P = 0.039）。本研究首次聚焦于血液透析队列中五聚体蛋白的年度变化。
