摘要
目的研究维持性血液透析（MHD）患者血管钙化、骨密度与血清骨保护素（OPG）及其配体sRANKL的相互关系。方法采用酶联免疫吸附法测定血清OPG、sRANKL水平；X线平片检测腹主动脉、股动脉及桡动脉部位血管钙化，计算血管钙化积分；双能X线骨密度仪测定腰椎及股骨骨密度。对各参数的相互关系进行统计分析。结果（1）39例MHD患者中25例（64．1％）在不同部位有不同程度的血管钙化，其中轻度钙化16例（41．0％），中重度钙化9例（23．1％）。中重度钙化者血清OPG水平、OPG／sRANKL比值显著高于轻度钙化者[（342．50±171．53）ng／L比（206．21±137．88）ng／L，t=-2．253，P=0．025；454．65±455．63比135．31±136．81，t=59，P=0．035]，而sRANKL水平差异无统计学意义[（0．10±0．08）pmol／L比（0．12±0．08）pmol／L，t=0．534，P〉0．05]。多元线性回归分析显示OPG／sRANKL是血管钙化评分的独立影响因素。（2）与骨量正常者比较，骨量异常者血清OPG水平升高[（249．05±137．66）ng／L比（226．67±170．12）ng／L]，sRANKL水平降低[（0．11±0．08）pmol／L比（0．12±0．02）pmol／L]，OPG／sRANKL比值升高（202．31±219．24比148．08±210．10），但差异均无统计学意义。多元线性回归分析显示OPG／sRANKL是腰椎T值的独立影响因素。（3）多元线性回归分析显示血管钙化评分是腰椎和股骨T值的独立影响因素。结论MHD患者血管钙化程度是腰椎及股骨骨密度的独立影响因素，OPG／sRANKL可能在血管钙化和骨密度的关系中起了纽带作用。
Objective To examine the interrelations among vascular calcification, bone density,osteoprotegerin （OPG） and soluble receptor activator of NF-κB ligand （sRANKL） in maintenance hemodialysis （MHD） patients. Methods The levels of serum OPG and sRANKL from 39 MHD patients were measured by ELISA. The vascular calcification was detected by plain radiographs. Bone mineral density （BMD） was measured with dual-energy X-ray absorptionmeter. Interrelations among above parameters were examined statistically. Results （1） Among 39 MHD patients, 25 cases were identified as vascular calcification by radiographic film. The proportion of patients with mild vascular calcification was 41.0% （16 cases）, moderate and severe vascular calcification was 23.1% （9 cases）. Compared to patients with mild vascular calcification, serum OPG level [（342.50±171.53） ng/L vs （206.21±137.88） ng/L,t=-2.253, P=0.025] and OPG/sRANKL ratio （454.65±455.63 vs 135.31±136.81, t=59, P=0.035）were significantly higher in patients with moderate and severe vascular calcification,while serum sRANKL level [（0.10± 0.08） pmol/L vs （0.12±0.08） pmol/L, t=0.534, P〉0.05] was not significantly different. Multiple linear regression analysis showed that OPG/sRANKL ratio was independent factor of vascular calcification score. （2）Compared to patients with normal bone volume, the patients with abnormal bone volume had higher serum OPG level [（249.05±137.66） ng/L vs （226.67±170.12） ng/L], lower serum sRANKL level [（0.11 ±0.08） pmol/L vs （0.12±0.02） pmol/L], and higher OPG/sRANKL ratio （202.31±219.24 vs 148.08±210.10）, but these parameters were not significantly different between these two groups. Multiple linear regression analysis showed that OPG/sRANKL ratio was an independent factor of T score of lumbar vertebra. （3）Muhiple linear regression analysis revealed that vascular calcification score was an independent factor of T score of lumbar vertebra and hip. Conclusions Vascular calcification score is an independent factor of BMD of lumbar vertebra and hip in MHD patients. Serum OPG/sRANKL ratio may play an important role in the association between vascular calcification and BMD in MHD patients.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2008年第7期456-460,共5页
Chinese Journal of Nephrology
关键词
肾透析
血管
钙质沉着症
骨密度
骨保护素
骨保护素配体
Renal dialysis
Blood vessels
Calcinosis
Bone density
Osteoprotegerin
Soluble receptor activator of NF-κB ligand
