抗血小板因子4/肝素抗体在血液透析患者动脉僵硬度进展中起重要作用。
Anti-Platelet Factor 4/Heparin Antibody Plays a Significant Role in Progression of Arterial Stiffness among Hemodialysis Patients.
作者信息
Kuo Chieh, Tsai Chiang-Chin, Chen Chien-An, Tsai Yueh-Feng, Chen Yen-Hsun
机构信息
Department of Cardiology.
Department of Surgery, Tainan Sinlau Hospital; ; Department of Health Care Administration, Chang Jung Christian University.
出版信息
Acta Cardiol Sin. 2017 Mar;33(2):188-194. doi: 10.6515/acs20160818b.
BACKGROUND
Arterial stiffness is a determinant of cardiovascular disease in end stage renal disease. Hemodialysis patients may develop anti-platelet factor 4/heparin antibody (PF4-H Ab) because of heparin treatment in dialysis. We tested whether PF4-H Ab was associated with progression of arterial stiffness in a 3-year follow-up.
METHODS
We enrolled 74 hemodialysis patients and studied their clinical, biochemical and arterial stiffness measurement with brachial-ankle pulse wave velocity (baPWV) over 3 years. Baseline and changes in baPWV after 3 years (ΔbaPWV) were collected and compared with related clinical and biochemical parameters. PF4-H Ab was evaluated by the enzyme-linked immunosorbent assay and titer ≥ 0.4 was defined to have PF4-H Ab.
RESULTS
We found a positive PF4-H Ab status in 25 of 74 patients. Mean baPWV was 16.1 ± 3.8 (m/s) at baseline and 17.6 ± 4.0 (m/s) after 3 years. Mean ΔbaPWV was 3.4 ± 2.2 (m/s) in the PF4-H Ab positive group, and 0.6 ± 1.2 (m/s) in the PF4-H Ab negative group. Baseline baPWV was only significantly associated with age (β = 0.49, p < 0.01). ΔbaPWV was significantly different between the PF4-H Ab positive and negative groups (p < 0.01). In multivariate regression analysis, only PF4-H Ab was positively associated with ΔbaPWV (β = 0.71, p < 0.01).
CONCLUSIONS
Our study concluded that PF4-H Ab was associated with progression of arterial stiffness in hemodialysis patients.
背景
动脉僵硬度是终末期肾病患者心血管疾病的一个决定因素。血液透析患者由于透析过程中使用肝素治疗，可能会产生抗血小板因子4/肝素抗体（PF4-H Ab）。我们在一项为期3年的随访研究中，检测了PF4-H Ab是否与动脉僵硬度的进展相关。
方法
我们纳入了74例血液透析患者，在3年时间里对他们进行了临床、生化指标检测，并采用肱踝脉搏波速度（baPWV）测量动脉僵硬度。收集基线时和3年后baPWV的变化值（ΔbaPWV），并与相关临床和生化参数进行比较。通过酶联免疫吸附测定法评估PF4-H Ab，将滴度≥0.4定义为存在PF4-H Ab。
结果
我们发现74例患者中有25例PF4-H Ab呈阳性。基线时平均baPWV为16.1±3.8（m/s），3年后为17.6±4.0（m/s）。PF4-H Ab阳性组的平均ΔbaPWV为3.4±2.2（m/s），PF4-H Ab阴性组为0.6±1.2（m/s）。基线baPWV仅与年龄显著相关（β=0.49，p<0.0１）。PF4-H Ab阳性组和阴性组之间的ΔbaPWV存在显著差异（p<0.01）。在多变量回归分析中，只有PF4-H Ab与ΔbaPWV呈正相关（β=0.71，p<0.01）。
结论
我们的研究得出结论，PF4-H Ab与血液透析患者动脉僵硬度的进展相关。
Zotero 插件