摘要
目的分析血清apelin、骨硬化蛋白(sclerostin)与维持性血液透析(MHD)患者腹主动脉钙化的相关性。方法选取厦门市海沧医院2019年1月—2020年1月行MHD(透析龄>6个月)的肾衰竭患者104例,根据腹部立位侧位片结果分成无钙化组(n=26例)与钙化组(n=78例)。另选取本院同期门诊健康体检者30例作为对照组。同时根据腹主动脉钙化评分(AACS)将钙化组分成轻度钙化组(n=14例)、中度钙化组(n=47例)、重度钙化组(n=17例)。比较3组年龄、男性占比、体质指数(BMI)、收缩压(SBP)、舒张压(DBP)、白蛋白(ALB)、碱性磷酸酶(ALP)、血肌酐(SCr)、血尿酸(UA)、葡萄糖(GLU)、血钙、血磷、血镁、血钾、甲状旁腺激素(iPTH)、血清apelin、sclerostin、25-羟维生素D3[25(OH)D3]。结果 (1)无钙化组、钙化组SBP、DBP、ALP、SCr、UA、血镁、血磷、血钾、iPTH、sclerostin高于对照组,ALB、25(OH)D3、apelin、血钙低于对照组(P<0.01)。(2)中度钙化组、重度钙化组apelin低于轻度钙化组,sclerostin高于轻度钙化组(P<0.05)。重度钙化组apelin低于中度钙化组,sclerostin高于中度钙化组(P<0.01)。(3)Pearson相关分析结果显示,AACS与sclerostin、血钙、血磷、ALP、UA、iPTH、SBP均呈明显正相关,与25(OH)D3、apelin、血镁呈负相关(P<0.05或P<0.01)。(4)Logisitic回归分析结果显示,血磷、iPTH、sclerostin、血钙为血管钙化的危险因素(P<0.05);血镁、25(OH)D3、apelin为血管钙化的保护因素(P<0.05)。结论 MHD患者血清apelin的低表达、sclerostin的高表达与腹主动脉钙化相关。
Objective To analysis the correlation between serum apelin、sclerostin and abdominal aortic calcification(AAC)in the patients with maintenance hemodialysis(MHD).Methods A total 104 patients with renal failure(The dialysis age is more than 6 months)who admitted to Haicang Hospital from January 2019 to January 2020 were selected for the study subjects.All the patients were divided into without calcification group(26 cases) and calcification group(78 cases)according to the abdominal aortic calcification.another 30 health people were as the control group.The 78 patients with abdominal aortic calcification were divided into mild calcification group(14 cases),moderate calcification group(47 cases) and severe calcification group(17 cases) according to the abdominal aortic calcification score(AACS).Contrast the difference of age、proportion of male、body mass index(BMI)、systolic blood pressure(SBP)、diastolic blood pressure(DBP)、serum albumin(ALB)、alkaline phosphatase(ALP)、Scrtinine(SCr)、uric acid(UA)、glucose(GLU)、calcium、 phosphorus、magnesium、kalium、intact parathyroid hormone(iPTH)、apelin、sclerostin and 25-hydroxyvitamin D3[25(OH)D3]. Results (1)The SBP、DBP、ALP、SCr、UA、magnesium、phosphorus、kalium、sclerostin、iPTH in the without calcification group and calcification group were higher than those in the control group,while All the ALB、25(OH)D3、 apelin and calcium in the without calcification group and calcification group were lower than those in the control group(all P<0.01).(2)The serum apelin in the moderate calcification group and severe calcification group were lower than those in the mild calcification group;The serum sclerostin in the moderate calcification group and severe calcification group were higher than those in the mild calcification group.serum apelin in the severe calcification group was lower than that in the moderate calcification group, serum sclerostin in the severe calcification group was higher than that in the moderate calcification group(P<0.01).(3)Pearson correlation analysis show that the levles of AACS were positively correlation with the sclerostin protein、calcium、phosphorus、ALP、UA、iPTH、SBP,but was negatively correlation with 25(OH)D3、apelin and magnesium(P<0.01 or P<0.05).(4)Logistic regression analysis show that phosphorus、iPTH、sclerostin、calcium were the independent risk factor for the vascular calcification,but magnesium、apelin and 25(OH)D3 the were the protective factor for the vascular calcification.Conclusion The low expression of apelin and high expression of sclerostin in MHD patients were correlated with abdominal aortic calcification.
作者
丁新国
叶美玲
梁李娜
覃静
肖琦
周溯源
陈志松
DING Xinguo;YE Meiling;LIANG Lina(Department of Nephrology,Haicang Hospital,Xiamen 361000,China)
出处
《临床合理用药杂志》
2021年第9期27-30,共4页
Chinese Journal of Clinical Rational Drug Use
