【摘要】 目的 探讨维持性血液透析(maintenance hemodialysis,MHD)患者Nod样受体蛋白3/白细胞介素-1β(Nod-like receptor protein 3/interleukin 1β,NLRP3/IL-1β)信号通路活化与高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)水平及动脉粥样硬化(atherosclerosis,AS)发生的关系。方法 行MHD治疗的患者83例为研究组，20例健康人为对照组，检测生化指标、HDL-C、血白细胞介素(IL)-1β、IL-18及外周血单核细胞NLRP3mRNA；测定颈动脉内膜中层厚度(intimamedia thickness,IMT)。比较2组间上述指标的差异；分析HDL-C及颈动脉IMT与NLRP3mRNA、IL-1β及IL-18的相关性；明确影响MHD患者HDL-C水平及颈动脉IMT的危险因素。结果 研究组MHD患者HDL-C低于对照组(t=-7.048,P<0.001)，颈动脉IMT值大于对照组(t=2.634,P<0.001)；血HDL-C与NLRP3mRNA(r=-0.682,P<0.001)、IL-1β(r=-0.537,P<0.001)及IL-18(r=-0.426,P<0.001)呈负相关；颈动脉IMT与NLRP3mRNA(r=0.521,P<0.001)、IL-1β(r=0.569,P<0.001)及IL-18(r=0.674,P<0.001)成正相关；NLRP3mRNA活化是HDL-C降低的危险因素(B=-0.390,p<0.001)，而NLRP3mRNA、IL-18活化(B=0.069、0.002，均P<0.001)及HDL-C降低(B=-0.106,P<0.001)是MHD患者颈动脉IMT增厚的危险因素。结论 NLRP3/IL-1β信号通路参与了MHD患者血HDL-C水平降低及颈动脉IMT增厚。更多还原

【Abstract】 Objective To investigate the relationship between of Nod-like receptor protein 3/interleukin-1β(NLRP3/IL-1β) signaling pathway activation and blood high-density lipoprotein cholesterol(HDL-C) level and atherosclerosis(AS) in patients with maintenance hemodialysis(MHD). Methods A total of 83 patients who underwent MHD were collected as the study group, and 20 healthy individuals as the control group.Their biochemical indexes, HDL-C, serum IL-1β, interleukin-18(IL-18) and NLRP3 mRNA were assayed,and the carotid intima-media thickness(IMT) was measured. The differences of these results were compared between the two groups. The correlations between HDL-C and NLRP3 mRNA, carotid artery IMT and NLRP3 mRNA, and IL-1β and IL-18 were analyzed respectively. The risk factors affecting HDL-C level and carotid IMT in MHD patients were explored. Results HDL-C level was lower in MHD patients than in the control group(t=-7.048,P<0.001), while carotid IMT value was higher in MHD patients than in the control group(t=2.634,P<0.001). HDL-C was negatively correlated with NLRP3 mRNA(r=-0.682, P<0.001), IL-1β=-0.537, P<0.01) and IL-18(r=-0.426, P<0.01). Carotid artery IMT was positively correlated with NLRP3mRNA(r=0.521, P<0.001), IL-1β(r=0.569, P<0.001) and IL-18(r=0.674, P<0.001). Hence, the activation of NLRP3 mRNA was the risk factor for low HDL-C level(B=-0.390, P<0.001), while the activation of NLRP3mRNA(B=0.069, P<0.001) and IL-18 signals(B=0.002, P<0.001) and the decrease of HDL-C(B=-0.106, P<0.001) were the risk factors for the increase of carotid IMT in MHD patients. Conclusion NLRP3/IL-1β signal pathway is involved in the decrease of blood HDL-C level and the thickening of carotid artery IMT in MHD patients.更多还原