血液透析患者血清hs-CRP Hcy MPO水平与冠状动脉粥样硬化的相关性分析

doi:10.3969/j.issn.1006-6233.2025.09.019

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摘要 目的: 观察血液透析患者血清超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)、髓过氧化物酶(MPO)水平及其与冠状动脉粥样硬化的相关性。方法: 于成都市第三人民医院2021年1月至2023年12月期间收治的血液透析患者中选取124例,按照冠状动脉造影检查结果将患者分为冠脉粥样硬化组与对照组,比较两组患者一般资料、血清hs-CRP、Hcy、MPO水平,血液透析患者冠状动脉粥样硬化的危险因素采用多因素Logistic回归分析,血清hs-CRP、Hcy、MPO水平与冠状动脉粥样硬化的相关性采用Spearman相关性分析。结果: 124例血液透析患者中,冠状动脉粥样硬化的患者有51例,占比41.13%,73例(58.87%)患者无冠状动脉粥样硬化。两组患者的一般资料中,透析龄、收缩压、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平差异有统计学意义(P<0.05)。相较于对照组,冠脉粥样硬化组血清hs-CRP、Hcy、MPO水平更高,差异有统计学意义(P<0.05)。Logistic回归分析显示,LDL-C、HDL-C与hs-CRP、Hcy、MPO水平均是血液透析患者冠状动脉粥样硬化的危险因素(P<0.05)。结论: 血液透析患者冠状动脉粥样硬化的发生除了与血清LDL-C、HDL-C有关以外,还与hs-CRP、Hcy、MPO水平密切相关,临床中应高度关注血液透析患者血清LDL-C、HDL-C与hs-CRP、Hcy、MPO水平变化,以尽早评估其冠状动脉粥样硬化风险并采取干预措施。

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关键词 ：血液透析, 冠状动脉粥样硬化, 超敏C反应蛋白, 同型半胱氨酸, 血浆髓过氧化物酶

Abstract：Objective: To observe serum levels of high-sensitivity C-reactive protein (hs-CRP), homocysteine (Hcy) and myeloperoxidase (MPO) in hemodialysis patients, and analyze their correlation with coronary atherosclerosis. Methods: Totally 124 hemodialysis patients admitted to the Third People's Hospital of Chengdu from January 2021 to December 2023 were selected. According to the results of coronary artery angiography, the patients were divided into coronary atherosclerosis group and control group. General information and serum hs-CRP, Hcy and MPO levels of the two groups were compared. The risk factors for coronary artery atherosclerosis in hemodialysis patients were analyzed using multiple Logistic regression, and the correlation between serum hs CRP, Hcy, MPO levels and coronary artery atherosclerosis was analyzed using Spearman correlation analysis. Results: Among 124 hemodialysis patients, 51 (41.13%) had coronary atherosclerosis, while 73 (58.87%) had no coronary atherosclerosis. In the general information of the two groups of patients, there were statistically significant differences in dialysis age, systolic blood pressurethe, the levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) between the two groups (P<0.05). Compared to the control group, the coronary atherosclerosis group exhibited significantly higher levels of serum hs-CRP, Hcy, and MPO, with statistically significant differences (P<0.05). Logistic regression analysis showed that, LDL-C, HDL-C, hs-CRP, Hcy, and MPO levels were risk factors for coronary atherosclerosis in hemodialysis patients (P<0.05). Conclusion: The occurrence of coronary arteriosclerosis in hemodialysis patients is not only related to serum LDL-C and HDL-C, but also closely related to hs CRP, Hcy, and MPO levels. In clinical practice, high attention should be paid to the changes in serum LDL-C, HDL-C, hs CRP, Hcy, and MPO levels in hemodialysis patients to assess their risk of coronary arteriosclerosis as early as possible and take intervention measures.

Key words： Hemodialysis Coronary arteriosclerosis High-sensitivity C-reactive protein Homocysteine Plasma myeloperoxidase

基金资助:国家自然科学基金,(编号:8227020778)

通讯作者: 裴晓玲

引用本文:

施雪婷, 叶滔, 兰凯, 郑晓菲, 符金娟, 裴晓玲. 血液透析患者血清hs-CRP Hcy MPO水平与冠状动脉粥样硬化的相关性分析[J]. 河北医学, 2025, 31(9): 1521-1525.
SHI Xueting, YE Tao, LAN Kai, et al. The Correlation between Serum Hs-CRP Hcy and MPO Levels and Coronary Atherosclerosis in Hemodialysis Patients. HeBei Med, 2025, 31(9): 1521-1525.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.09.019 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I9/1521

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