ABSTRACT
Objective To understand the prevalence,treatment and influence factors of hypertension in maintenance hemodialysis (MHD) patients in Anhui Province.Methods A total of 2724 adult patients on MHD from January 1st 2014 to March 31st 2014 in 26 hospitals of southern,northern and central Anhui Province were investigated.Their demographic characteristics,primary disease,complications,medications,dialysis and laboratory examination were explored.The prevalence treatment rate and control rate of hypertension were analyzed.Associated factors for controlling hypertension [systolic blood pressure (SBP) ＜ 140 mmHg and diastolic blood pressure (DBP) ＜ 90 mmHg] were assessed by logistic regression analysis.Results (1) The prevalence of hypertension in the hemodialysis patients was 87.0％.Their treatment rate and control rate were 93.2％ and 23.9％ respectively.The average of SBP was (145.90±21.18) mmHg,and the DBP on average was (83.60± 12.21) mmHg.The most commonly used anti-hypertensive drug is calcium channel blocker (88.2％).Over one third (45.7％) of patients were treated with two kinds of anti-hypertensive drug,26.2％ with 1 kind,21.7％ with 3 kinds,and 6.4％ with 4 kinds or more.(2) Compared with non-hypertension patients,patients with hypertension have older age,higher body mass index (BMI),phosphorus,SBP and DBP,as well as lower hemoglobin and Kt/V (all P ＜ 0.05).(3) The multivariate logistic regression analysis showed that Ca ＞ 2.50 mmol/L (OR=2.084,95％CI 1.008-4.307,P=0.047) positively correlated with controlling hypertension,while smoke (OR=0.594,95％CI 0.356-0.911,P=0.046) and BMI 18.5 ～ 23.9 kg/m2 (OR=0.516,95％CI 0.293-0.907,P=0.022) negatively correlated with it.Conclusions High prevalence yet low control rate of hypertension in MHD patients in Anhui Province were observed.Hypocalcemia may be a protective factor for hypertension control,while smoke and BMI may be risk factors for it.
ABSTRACT
Objective To investigate the level of CD73 expression in CD4+ regulatory T(Treg) cells in patients with systemic lupus erythematosus ( SLE ) and explore its role in the pathogenesis of SLE.Methods We selected 29 untreated/active SLE patients and 22 healthy controls. Frequencies of CD4+ CD25+CD73+ T cells and levels of FOXP3 protein expressed in CD4+ CD73+ CD4+ CDhi25, CD4+ CDhi25, CD4+ CD25+ T cells were analyzed by flow cytometry. Meanwhile, the levels of SLE disease activity index ( SLEDAI), C reactive protein (CRP), ESR,immunoglobulin and complement were measured. Results The percent of CD4+ CD25+ CD73+ T cells was decreased in new-onset SLE compared with healthy controls[(1.25±1.32) % vs (2.35±1.09) %, P ＜0. 01], and it had no correlation with the levels of SLEDAI, CRP, ESR, et al and anti-C1qand anti-nucleosome antibodies ( P ＞ 0.05 for each). Both in groups of new-onset SLE and healthy controls, CD73 level expressed in CD4+ CDhi25CDhi25T cells[(29.05 ± 12. 53)%, (43.35 ± 10. 09)%]was higher than that expressed in CD4+ CD25+ T cells[( 17.48 ± 6. 92 ) %, ( 29. 98 ± 10. 39 ) %, P ＜ 0.01]. In both SLE patients and healthy controls, levels of FOXP3 protein expressed in CD4+ CD73+ T cells[(65. 36 ± 14. 40)%,(63.80±14.05)%]and CD+4 CDhi25CD4+ CDhi25 T cells[(67. 30 ± 13.04)%, (56. 30 ±9. 21 )%]were higher than those in CD4+ CD25+T cells[(45.70 ± 12. 74)%, (43.98 ±5. 17)% ,P ＜0. 001], while it had no significant difference between the CD4+ CDhi25CD4+ CDhi25 and CD4+ CD73+ T cells(P＞0.05). Conclusion These results demonstrate that CD73 may be a new surface marker of regulatory T cells, and the abnormal expression of CD73 in Treg cells may participate in the pathogenesis of SLE.