Study on the relationship between carotid atherosclerosis and high-sensitivity Creative protein,lipoprotein-a and superoxide dismutase in patients with chronic renal failure / 中国综合临床

ABSTRACT

Objective To study the association of carotid atherosclerosis with high-sensitivity creative protein(hs-CRP),lipoprotein-a(Lp-a) and superoxide dismutase(SOD) in patients with chronic renal failure (CRF).Methods Seventy-one CRF patients were divided into Group A of 45 patients under maintenance hemodialysis and Group B of 26 patients without hemodialysis,and 20 healthy donor was Group C in this study.And 71 CRF patients were divided into carotid atherosclerosis group (43 cases) and non carotid atherpsclerosis group(28 cases) according to whether the carotid atherosclerosis plaque was detected out.Fortythree CRF patients presented carotid atherosclerosis including 17 patients with soft plaque,10 patients with hard plaque and the other 16 with mixed plaque.Color ultra-sound was used to measure the carotid intimal medial thickness(IMT) and define the type of plaque.Levels of hs-CRP,Lp (a) and SOD were detected and analyzed in this study.Results (1) Levels of hs-CRP,Lp-a,SOD and IMT were significantly different in group A ((7.39±2.25) ag/L,(428.43±102.25) mmol/L,(71.35±21.52) KU/L and (1.23±0.31) mm,respectively),group B((7.41±1.67) mg/L,(432.12±96.43) mmol/L,(68.14±15.25) KU/L and (1.18±0.26) mm,respectively),and group C ((2.11 ± 0.86) mg/L,(193.32 ± 62.31) mmol/L,(94.23 ± 21.13)KU/L and (0.61 ±0.22) mm,respectively),the differences were significant (F =2.998,2.783,2.032,2.802;P＜0.05).Plaque incidence was increased in group A(68.9％) and group B(69.2％) compared with group C (12.5％) with statistical significance (x2=17.863,17.989;P＜0.001).(2) Furthermore,for CRF patients,hsCRP and Lp-a were positively related to IMT in group A (r =O.436,0.279;P＜0.05) and group B (r =0.652,0322;P ＜ 0.05),SOD presenting negative relationship with IMT (r =-0.283,P ＜ 0.01 for group A,and r =-0.164,P＜0.05 for group B).(3) Level of hs-CRP and Lp-a in carotid atherosclerosis group were higher than those in non carotid atherosclerosis group((7.58±2.47) mg/L vs.(3.41±1.26) mg/L,(437.31±115.38) mmol/L vs.(256.24± 101.22) mmol/L),the differences were significant (t =2.917,2.583;P ＜0.05).Level of SOD in carotid atherosclerosis group was lower than that in non carotid atherosclerosis group ((68.43±13.36) KU/L vs.(76.22±17.12) KU/L),the difference was signifiant(t=2.156,P＜0.05).(4)Level of hs-CRP and SOD in patients with soft plaque and mixed plaque were statistically different from those in patients with hard plaque(F=4.210,2.056;P＜0.05).Conclusion The micro-inflammatory status,oxidative stress and disturbance of Lp-a metabolism are extensively existed in CRF patients and closely connect to each other.Therefore,they might correlate with the formation of plaques in carotidartery.