ABSTRACT
Objective· To observe the progression of left ventricular hypertrophy (LVH) in maintenance hemodialysis (MHD) patients,and to analyse risk factors of the progression of LVH.Methods· Stable MHD patients of Ruijin Hospital,Shanghai Jiao Tong University School of Medicine were enrolled in July 2012.These patients were followed for 1 year.Clinical characteristics and laboratory indices were collected at baseline and 1-year followup.Left ventricular mass (LVM) was evaluated by ultrasonic cardiogram.Left ventricular mass index (LVMI) increased more than 5％ was defined as LVH progression.Results · Totally 71 MHD patients were enrolled in this study.44 patients were males,with median age 55.9 years old,median dialysis vintage 152.1 months.22 (30.99％) patients had LVH at enrollment.A significant higher percentage of MHD patients used calcium-channel binder (CCB) and angiotensin-converting-enzyme inhibitor (ACEI) in LVH group,while a significant higher NT-proBNP level was also showed in LVH group.31 patients had LVH progression while 40 patients didn't after 1 year.Patients in progression group had significant higher levels of total cholesterol and low-density lipoprotein cholesterol (LDL-C).In univariable and multivariable Logistic regression,total cholesterol and LDL-C were independent risk factors of LVH progression (OR=2.515,95％ CI 1.219-5.910,P=0.013;OR=1.950,95％ CI 1.127-3.375,P=0.017).Conclusion · LVH is one of the common cardiovascular complications in MHD patients.The proportion of use of antihypertensive drugs is higher in the patients with LVH.Higher LDL-C and total cholesterol levels are risk factors for the progression of LVH.
ABSTRACT
Objective Despite regular treatment,antineutrophil eytoplasmie antibodies(ANCA)asso- ciated systemic vasculitis(AASV),in which the role of Fc?Rs has been established,are still associated with significant long-term mortality and remain an important cause of end-stage renal failure.ANCA plays an im- portant role in the pathogenisis of primary systemic small vessel vasculitis(PSV)by their potential to activate neutrophils.Because the interaction between ANCA and its receptors on the Fc portion of immunoglobulins (Fc?R)on neutrophils is essential in the activation process,we investigate the inhibitory,effect of tg19320 on ANCA induced activation of neutrophils,which is a tetrameric tripeptide that interferes with IgG/Fe?Rs in- teraction.Methods We prepared tg19320 by solid-phase peptide syntbesis.The binding between tg19320 and human IgG was assessed by enzyme-linked immunosorbent assay.The biological activity of tg19320 to intefere with FcF?receptor recognition was identified by rosette formation assay.ANCA IgG was prepared from the sera of active Wegener's granulomatosis(WG)and microscopic polyangiitis(MPA)patients.Neu- trophils isolated from the blood of healthy volunteers were primed with TNF-?(2 ng/ml)and then incubated with ANCA IgG(200?g/ml),or pretreated with tg19320(2.5 mg/ml)and then added with ANCA IgG.Su- peroxide burst of neutrophils was determined by Ferri-cytochrome reduction assay.Results We found that tg19320 bound tightly to human IgG in a dose dependent manner and the inhibition of the rosette formation between SRBC-IgG and U937 cells was statistically significant(20.3% vs 53.2%,P