血液透析患者血浆硫酸吲哚酚与左心室肥厚的相关性被引量：4

Relationship between plasma levels of indoxy sulfate and left ventricular hypertrophy in hemodialysis patients

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摘要目的探究血液透析患者左心室肥厚的相关危险因素。方法纳入慢性肾脏病(CKD)血液透析患者190例,检测生化指标,进行心脏超声检查,将患者分为左心室肥厚组和非左心室肥厚组。采用高效液相色谱-电喷雾-串联质谱技术对血浆中硫酸吲哚酚(IS)进行检测。采用Spearman相关或Pearson相关分析IS与其他生化或临床指标的关系。采用线性回归分析IS与左心室质量指数(LVMI)的关系,同时采用Logistic回归模型分析IS和左心室肥厚(LVH)的关系。结果共入组190例,男117例,女73例,年龄(57.3±14.2)岁,LVH患病率达65.8%。单因素线性回归显示,血浆硫酸吲哚酚(IS)与左心室质量指数(LVMI)呈正相关(β=7.05,P=0.01),校正各种危险因素后,IS与LVMI仍呈正相关(β=4.1,P=0.02)。采用Logistic回归分析硫酸吲哚酚(IS)与左心室肥厚(LVH)的关系,校正各种危险因素后,血浆硫酸吲哚酚(IS)与左心室肥厚(LVH)独立正相关(β=6.55,OR=0.70,95%CI=0.63~0.77,P=0.03)。结论 CKD血液透析患者血浆IS与LVMI呈独立正相关,血浆IS是LVH的独立危险因素。 Objective To explore the risk factors of left ventricular hypertrophy （LVH） in hemodialysis patients. Methods Totally 190 cases of chronic renal disease undergoing hemodialysis were included. The clinical data was collected, and the biochemical indexes measurement and cardiac ultrasound examination were performed. The patients were divided into LVH group and non-LVH group. Plasma indoxyl sulfate （ IS ） concentration was determined by high performance liquid chromatography electrospray tandem spectrometry. The relationship between IS and other clinical or biochemical indexes was analyzed by Pearson or Spearman correlation. Linear regression or Logistic regression model was used to analyze the relationship of IS with LVMI or with LVH respectively. Results Totally 190 patients aged （57. 3 ± 14. 2） were included, with 117 males and 73 females. The prevalence of LVH was 65.8 %. Single factor linear regression showed that plasma IS was positively correlated with LVMI （ β =7.05,P =0. 01 ）. After adjusting for various risk factors, IS was positively correlated with LVM[ （ β = 4. 1, P = 0. 02 ）. Results of Logistic regression models showed that plasma IS was independently associated with LVH after adjustment for other confounding risk factors （ β = 6. 55,0R -0. 70,95% CI=0. 63 -0. 77,P =0. 03）. Conclusion Plasma IS is correlated with LVMI in hemodialysis patients with CKD independently and positively, and it is an independent risk factor for LVH.

作者雒华贺晓莉杨小娟刘晓华 LUO Hua;HE Xiao-li;YANG Xiao-juan;LIU Xiao-hua(Department of Nephrology, Yan＇an University Affiliated Hospital, Yan＇an 716000, China)

机构地区延安大学附属医院肾内科

出处《实用药物与临床》 CAS 2018年第4期399-405,共7页 Practical Pharmacy and Clinical Remedies

关键词左心室肥大血液透析硫酸吲哚酚尿毒症毒素 Left ventricular hypertrophy Hemodialysis Indoxyl sulfate Uremic toxin

分类号 R459.5 [医药卫生—治疗学]

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1吴逸如,刁宗礼,刘文虎.硫酸吲哚酚对肾脏和心血管毒性作用的研究新进展[J].临床和实验医学杂志,2015,14(1):69-72. 被引量：9
2白运焕,杨媛媛,蒋亚芬,蒋云生.慢性肾病患者血硫酸吲哚酚浓度与心血管疾病相关指标的关系分析[J].中华全科医学,2016,14(7):1141-1143. 被引量：7
3余彦霖,肖堂利,刘亮,何婷,徐新丽,管旭,杨可,赵景宏.硫酸吲哚酚促进肾纤维化的机制研究[J].第三军医大学学报,2016,38(2):119-123. 被引量：5
4何栩,吴奕章,傅强,严全能,梁欣伟,李志樑.硫酸吲哚酚对人单核细胞源树突状细胞表型及功能的影响[J].实用医学杂志,2017,33(2):194-197. 被引量：3
5安凌春,高杨,黄春泉.连续性肾脏替代治疗与间歇性血液透析治疗重症急性肾功能衰竭的效果研究[J].中国当代医药,2017,24(13):60-62. 被引量：16

二级参考文献79

1De Loor H, Meijers BK, Meyer TW, et al. Sodium octanoate to reverse indoxyl sulfate and p - eresyl sulfate albumin binding in uremic and nor- real serum during sample preparation followed by fluorescence liquid chromatography [ J ]. J Chromatogr A, 2009,1216 (22) :4684 - 4688.
2Deguehi T, Ohtsuki S, Otagiri M, et al. Major role of organic anion transporter 3 in the transport of indoxyl sulfate in the kidney [ J ]. Kid- ney Int, 2002,61 ( 5 ) : 1760 - 1768.
3Pretorius C J, MeWhinney BC, Sipinkoski B, et al. Reference ranges and biological variation of free and total serum indoxyl - and p - eresyl sulphate measured with a rapid UPLC fluorescence detection method [ J]. Clin Chim Acta, 2013,419 : 122 - 126.
4Fang CY, Lu JR, Chen BJ, et al Selection of uremic toxin - reducing probioties in vitro and in vivo[J]. J Funet Foods, 2014,7:407 -415.
5Lan Z, Bi KS, Chen XH. Ligustrazine attenuates elevated levels of in- doxyl sulfate, kidney injury molecule - 1 and elusterin in rats exposed to cadmium[ J]. Food Chem Toxieol, 2014,63:62 - 68.
6Kim SH, Yu MA, Ryu ES, et al. Indoxyl sulfate - induced epithelial - to - mesenchymal transition and apoptosis of renal tubular cells as novel mechanisms of progression of renal disease [J]. Lab Invest, 2012,92 (4) :488 -498.
7Sun CY, Chang SC, Wu MS. Suppression of Klotho expression by pro- tein- bound uremic toxins is associated with increased DNA methyl- transferase expression and DNA hypermethylation [ J ]. Kidney Int, 2012,81 (7) :640 -650.
8Sun CY, Chang SC, Wu MS. Uremic toxins induce kidney fibrosis by activating intrarenal renin- angiotensin- aldosterone system associated epithelial - to - mesenchymal transition [ J ]. PLoS One, 2012,7 ( 3 ) : e34026.
9Sun CY, Hsu HH, Wu MS. p - Cresol sulfate and indoxyl sulfate in- duce similar cellular inflammatory gene expressions in cultured proximal renal tubular cells[ J]. Nephrol Dial Transplant, 2013,28 ( 1 ) : 70 - 78.
10Motsjinm M, Hosokawa A, Yamato I-I, et al. Uremic loxlns of organic Anions up - regulate PAI- 1 expression by induction of NF - kappaB and free radical in proximal tubular eelIs[ J ]. Kidney lnt, 2003,63 (5) : 1671 - 1680.