Department of Blood Purification, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Ren Fail. 2020 Nov;42(1):1076-1082. doi: 10.1080/0886022X.2020.1832522.
Carpal tunnel syndrome (CTS) is a common complication in maintenance hemodialysis (MHD) patients and leads to disabilities and increased risk of mortality. Hepatitis C virus (HCV) infection is associated with inflammatory and oxidative stress, and HCV infection can be cured. This study aimed at evaluating the association of HCV infection with CTS.
Using a cross-sectional design, anthropometric and laboratory data were collected. Serum β-microglobulin, HCV antibody and HCV-RNA were measured. CTS was diagnosed according to clinical manifestation, electrophysiological test or ultrasonography. The related factors for CTS were analyzed by multivariate logistic regression.
This study included 113 participants, of whom 33 (29.2%) patients were positive for HCV antibody and 18 (15.9%) were positive for HCV antibody and HCV-RNA. Thirty-two (28.3%) patients were diagnosed with CTS. There were significant differences in the dialysis vintage, age of onset of MHD, high-sensitivity C-reactive protein, serum βM, anti-HCV-positive, HCV-RNA-positive, HCV load values and urine volume category between the CTS group and non-CTS group ( < 0.05). High-sensitivity C-reactive protein (OR: 1.238, 95% CI: 1.071-1.431, = 0.004), dialysis vintage (OR: 1.017, 95% CI: 1.008-1.026, < 0.001) and HCV-RNA-positive (OR: 5.929, 95% CI: 1.295-27.132, = 0.022) rather than anti-HCV-positive were related factors for CTS.
High-sensitivity C-reactive protein, dialysis vintage and HCV-RNA replication but not previous HCV-infection were related factors for CTS in MHD patients. Further studies are needed to clarify whether intervention is beneficial for preventing and delaying the progression of CTS in MHD patients with HCV-RNA replication.
腕管综合征（CTS）是维持性血液透析（MHD）患者的常见并发症，可导致残疾和死亡率增加。丙型肝炎病毒（HCV）感染与炎症和氧化应激有关，且 HCV 感染可被治愈。本研究旨在评估 HCV 感染与 CTS 的关系。
采用横断面设计，收集人体测量学和实验室数据。检测血清β-微球蛋白、HCV 抗体和 HCV-RNA。根据临床表现、电生理学检查或超声检查诊断 CTS。采用多因素 logistic 回归分析 CTS 的相关因素。
本研究共纳入 113 名参与者，其中 33 名（29.2%）患者 HCV 抗体阳性，18 名（15.9%）患者 HCV 抗体和 HCV-RNA 均阳性。32 名（28.3%）患者被诊断为 CTS。CTS 组和非 CTS 组在透析龄、MHD 发病年龄、高敏 C 反应蛋白、血清βM、抗 HCV 阳性、HCV-RNA 阳性、HCV 载量值和尿量分类方面差异有统计学意义（<0.05）。高敏 C 反应蛋白（OR：1.238，95%CI：1.071-1.431，=0.004）、透析龄（OR：1.017，95%CI：1.008-1.026，<0.001）和 HCV-RNA 阳性（OR：5.929，95%CI：1.295-27.132，=0.022）而非抗 HCV 阳性是 CTS 的相关因素。
高敏 C 反应蛋白、透析龄和 HCV-RNA 复制而不是既往 HCV 感染是 MHD 患者 CTS 的相关因素。需要进一步研究以阐明干预是否有益于预防和延缓 HCV-RNA 复制的 MHD 患者 CTS 的进展。
