血液透析患者血浆胎球蛋白A水平及其与血管钙化的关系  

Relationship between plasma fetuin-A and vascular calcification in hemodialysis patients

作　　者：王宓[1] 王梅[1] 甘良英[1] 李四君[2] 张萌[2] 

机构地区：[1]北京大学人民医院肾内科,北京100044 [2]北京大学人民医院 放射科,北京100044

出　　处：《中国血液净化》2007年第5期263-266,共4页Chinese Journal of Blood Purification

摘　　要：目的观察血液透析患者血管钙化的发生情况,探讨血浆胎球蛋白A水平与血管钙化的关系。方法收集北京大学人民医院入选血液透析患者的人口学及临床资料,用X线平片对腹部、骨盆、手部进行血管钙化的定量测量,并检测血胎球蛋白A及C反应蛋白、全段甲状旁腺激素(iPTH)等与血管钙化相关的指标,进行相关分析。结果入选50例血液透析患者,X线平片显示66．0％(33例)有不同程度、不同部位的血管钙化。存在血管钙化的患者中90．9％有腹主动脉钙化,36．4％存在中小动脉(包括髂动脉、股动脉、桡动脉、手指动脉)钙化,有中小动脉钙化的患者中75．0％存在腹主动脉钙化。另外中重度血管钙化者占33．3％。中、重度血管钙化与轻度血管钙化患者比较,年龄更大,男性比例高,糖尿病比例高,舒张压低(P<0．05)。血液透析患者血浆胎球蛋白A水平较健康对照组明显降低(P <0．01),中、重度血管钙化的血液透析患者血浆胎球蛋白A水平明显低于无／轻度钙化患者(P<0．01)。多元线性回归分析显示血管钙化积分、血白蛋白水平是血胎球蛋白A浓度的独立影响因素。结论血液透析患者普遍存在血管钙化,以腹主动脉钙化为突出表现,血管钙化积分、白蛋白水平是血胎球蛋白A浓度的独立影响因素。Objective To observe vascular calcification and to investigate the relationship between plasma fetuin-A level and vascular calcification in hemodialysis patients. Methods Fifty hemodialysis patients were enrolled in this study. Vascular calcification was quantitatively evaluated by plain X-ray films of abdomen, pelvis and hands. Demographic and clinical data were collected. Plasma fetuin-A and other parameters related to calcification were examined. Results Vascular calcification on X-ray films presented in 33 cases （66%）. Of the 33 cases, 90.9% and 36.4% case were found to have calcification on abdominal aorta and peripheral arteries, respectively, and 33% cases were found to have moderate to severe degree of calcification. In patients with calcification of peripheral arteries, 75 % of them were accompanied by abdominal aorta calcification. Moderate to severe degree of calcification usually occurred in male patients of older age and in those complicated with diabetes or having lower diastolic blood pressure （P〈0.05）. Plasma fetuin-A was lower in hemodialysis patients than in healthy control （P〈0.01）. Lower plasma fetuin-A was frequently seen in patients with moderate to severe vascular calcification （P〈0.01）. Stepwise regression analysis indicated that score of vascular calcification and serum albumin concentration were the independent factors affecting plasma fetuin-A level. Conclusions Vascular calcification is commonly present in hemodialysis patients. The calcification usually locates on abdominal aorta. Score of vascular calcification and serum albumin concentration are two independent factors affecting plasma fetuin-A level.

关 键 词：血液透析 血管钙化 X线平片 胎球蛋白A 

分 类 号：R543[医药卫生—心血管疾病]