| Objective: To investigate the effects of high sensitivity C reactive protein (hs-CRP) , interleukin 6(IL-6) and tumor necrosis factor-α(TNF-α) on left ventricular remodeling in patients with peritoneal dialysis.Methods: Forty-five patients with peritoneal dialysis were selected,who had undergone peritoneal dialysis for more than three months and were in a stable clinic status without signs of acute infections or other progressive diseases.Serum hs-CRP, IL-6 and TNF-αwere measured by enzyme-linked immunosorbent assay(ELISA). The levels of haematoglobin (Hb), albumin (ALB), creatinine (SCr), total cholesterol(TC),triglyeride (TG) and so on were measured meanwhile. Urine and peritoneal dialysate of patients with dialysis were collected and serum urea nitrogen(BUN), creatinine (SCr) and glucose(Glu) were measured to calculate residual renal function (RRF) and urea kinetics (KT/V) per week of patients. The left atrial diameter(LAD),1eft ventricular end diastolic diameter(LVDd),inter ventricular septal thickness(IVST),left ventricular posterior wall thickness( LVPWT)and left ventricular ejection fraction (LVEF) were measured by ultrasonic cardiography.Result:1. serum hs-CRP, IL-6 and TNF-αwere significantly higher in patients than those in the normal control group(P<0.01).According to the hsCRP levels, these patients were divided into two groups, hs-CRP elevated group and the normal group. The level of Ferritin in hs-CRP elevated group was significantly higher than the normal group(P<0.05),and the level of Albumin(Alb) and prealbumin(PA) were significantly lower(P<0.01,P<0.05) . TG and PTH were not different between the two group patients(P>0.05),ALB and PA were negatively correlated with hs-CRP (r=-0.424,-0.536, P<0.01,P<0.05) ; Hb, LB and PA were negatively correlated with TNF-α(r=-0.362,-0.417,0.414, P<0.01,P<0.05); ALB and PA were negatively correlated with IL-6 (r= -0.426,-0.332, P<0.01, P<0.05). serum hs-CRP, and TNF-αwere positively correlated with the values of Ferritin(r=0.362,0.297, P<0.05). The level of hs-CRP, IL-6 and TNF-αin the RRF≥6.5ml/min group were significantly lower than the RRF<6.5ml/min group, and the KT/V<2.0 group showed significantly higher level of hs-CRP, IL-6 and TNF-αthan the KT/V≥2.0 group.2.The UCG showed that 68.9% of patients with Peritoneal Dialysis had LVH. Incidence rate of left ventricular concentric hypertrophy , left ventricular eccentric hypertrophy ,left ventricular concentric remodeling were 33.3%,35.6% and 13.3%.The rate of left ventricular diastolic dysfunction and systolic dysfunction were 64.4% and 8.9%.3.The average serum hs-CRP, IL-6 and TNF-αwere positively correlated with the values of LAD, LVDd ,LVDs ,LVMI (P<0.05 or P <0.01),but negatively corre1ated with the value of LVEF (P<0.05).The mean level of hs-CRP was positively correlated with levels of IL-6 and TNF-α(P <0.01) hs-CRP, IL-6, PTH, Ca×P were independent influencing factors of left ventricular hypertrophy .Conculusion:1 There is microinflammatory state in the patients with Peritoneal Dialysis, and microinflammatory state maybe related with hypoproteinemia, inadequate dialysis and RRF.2 The incidence of cardiovascular diseases in patients with Peritoneal Dialysis is high. LVH and left ventricular diastolic dysfunction are more frequently happened.3 The inflammatory factors are probably involved in the presence and progression of left ventricular remodeling in patients with Peritoneal Dialysis.
|
PDF Full Text Request