摘要
目的:探讨糖尿病肾病CKD-Ⅴ期患者血清补体C1q肿瘤坏死因子相关蛋白3(CTRP3)、补体C1q肿瘤坏死因子相关蛋白9(CTRP9)变化与血管钙化的关系。方法:将西电集团医院2016年7月至2018年7月收治的72例糖尿病肾病CKD-Ⅴ期患者纳入病例组,选取同一时间来该院体检的72例健康体检者纳入对照组。病例组根据胸部X线片主动脉弓钙化情况分为非血管钙化组(非钙化组,49例)和合并血管钙化组(钙化组,23例)。采用双抗夹心酶联合免疫吸附法测定血清CTRP3、CTRP9。采用单因素方差分析比较3组血清CTRP3、CTRP9等指标差异,多因素Logistic逐步回归分析探讨糖尿病肾病CKD-Ⅴ期患血管钙化的危险因素。结果:3组血清CTRP3、CTRP9水平比较差异均有统计学意义(均P <0. 05),其中非钙化组血清CTRP3、CTRP9水平明显低于对照组,钙化组血清CTRP3、CTRP9水平明显低于对照组与非钙化组,差异均有统计学意义(均P <0. 05)。采用χ2检验对血管钙化的实验相关影响因素进行单因素分析,结果发现年龄及血清CTRP3、CTRP9、TC、LDL-C水平等因素差异具有统计学意义(P <0. 05)。Logistic逐步回归分析结果显示患者年龄<46岁、TC水平<5. 83 ng·ml-1、LDL-C水平<3. 45 mmol·L-1为糖尿病肾病CKD-Ⅴ期患者血管钙化的保护因素,CTRP3水平<0. 78 ng·ml-1、CTRP9水平<10. 47 ng·ml-1为糖尿病肾病CKD-Ⅴ期患者血管钙化的危险因素。结论:糖尿病肾病CKD-Ⅴ期患者血清CTRP3、CTRP9可能具有抗血管钙化的作用,其水平升高是糖尿病肾病CKD-Ⅴ期患者血管钙化的保护因子。
Objective: To investigate the relationship between changes of serum C1 q tumor necrosis factor related protein( CTRP) 3,CTRP9 and vascular calcification( VC) in chronic kidney disease stage 5( CKD-Ⅴ) patients with diabetic nephropathy( DN). Methods: 72 CKD-Ⅴ patients with DN( case group) and 72 cases of health examinees( control group) in Xidian Group Hospital from July 2016 to July 2018 were selected. The case group was further divided into non-vascular calcification group( n = 49) and vascular calcification group( n = 23) according to chest X-ray results. Serum CTRP3 and CTRP9 were determined by double-antibody sandwich enzyme combined with immunosorbent assay. One-way analysis of variance was used to compare the differences of serum CTRP3 and CTRP9 in three groups. Multivariate logistic stepwise regression analysis was used to explore the risk factors of vascular calcification in CKD-Ⅴ patients with DN. Results: The levels of CTRP3 and CTRP9 had statistic differences among the three groups( P < 0. 05),which ranked in a descending order was control group,noncalcification group and calcification group( P < 0. 05). Univariate analysis testing by χ2 showed that factors influencing vascular calcification including age, serum CTRP3, CTRP9, TC and LDL-C were statistically significant( P < 0. 05). Logistic stepwise regression analysis showed that patients aged < 46 years,TC < 5. 83 ng·ml-1,and LDL-C < 3. 45 mmol·L-1 were protective factors for vascular calcification in CKD-Ⅴ patients with DN,while patents with CTRP3 < 0. 78 ng·ml-1,CTRP9 < 10. 47 ng·ml-1 were risk factors for CKD-Ⅴ patients with DN. Conclusion: Serum CTRP3 and CTRP9 may have anti-vascular calcification effect,so the elevated levels of two indicators are protective factors of vascular calcification in CKD-Ⅴ patients with DN.
作者
贺晓雯
徐玉祥
张九芝
马刚
HE Xiaowen;XU Yuxiang;ZHANG Jiuzhi;MA Gang(Department of Renal Medicine,Xidian Group Hospital,Xi'an 710077,China;Department of Renal Medicine,the Affiliated Hospital of Northwest University(Xi'an Third Hospital),Xi'an 710000,China)
出处
《现代医学》
2019年第9期1075-1080,共6页
Modern Medical Journal
基金
陕西省社会发展科技攻关项目(2016SF-183)
