胎球蛋白A与慢性肾脏病患者肾小球过滤及颈动脉钙化的关系  

Relations of fetuin- A with estimated glomerular filtration rate and carotid artery calcification in patients with chronic kidney disease

作　　者：詹俊琳[1] 梁剑波[2] 王泽彬[2] 

机构地区：[1]广州医科大学附属第二医院儿科,广东广州510260 [2]广州医科大学附属第二医院肾内科,广东广州510260

出　　处：《南方医科大学学报》2013年第11期1689-1691,共3页Journal of Southern Medical University

基　　金：广东省科技计划项目(2007B031503009)

摘　　要：目的研究血清胎球蛋白A(fetuin-A)与慢性肾脏病患者(CKD)残存肾功能的关系及其对颈动脉钙化的影响。方法采集CKD3期、4期、5期各20例患者的血液样本,检测血清肌酐、钙、磷、白蛋白、脂蛋白及胆固醇水平,应用MDRD公式采用血清肌酐计算肾小球滤过率(eGFR),采用免疫酶联吸附法(ELISA)测定Fetuin-A值,颈动脉彩色超声检测颈动脉钙化。结果随着eGFR的下降,Fetuin-A水平在CKD4期患者明显低于CKD3期(P<0.05),CKD5期明显低于CKD4期(P<0.05),Fetuin-A与eGFR呈线性正相关;颈动脉钙化的发生率随eGFR下降逐渐增加,CKD5期颈动脉钙化发生率最高,等级相关分析显示FetuinA与颈动脉钙化的发生呈负相关,Logistic回归分析显示血浆Fetuin-A水平降低是ESRD患者颈动脉钙化的危险因素。结论Fetuin-A血浆浓度随肾功能下降逐渐下降,是CKD患者颈动脉钙化发生的危险因素之一。Objective To investigate the association of fetuin-A with residual renal function and carotid artery calcification in patients with chronic kidney disease （CKD）. Methods Blood examples were collected form 60 CKD patients in stages CKD3 to CKD5 （20 patients per stage） for measurement of serum fetuin-A, albumin, calcium, phosphorus and parathyroid hormone, cholesterol, triglycercide, low-density lipoprotein, and high-density lipoprotein. MDRD equation was used to calculate the estimated glomerular filtration rate （eGFR）, and ELISA was used to detect serum fetuin-A. Color Doppler ultrasound was performed to measure carotid intima-media thickness （CIMT）. Results As the eGFR decreased, serum fetuin-A significantly decreased in CKD5 stage compared with that in CKD4 stage （P〈0.05）; compared with that in CKD3 stage, serum fetuin-A level was significantly lowered in CKD4 stage （P〈0.05）. Linear regression analysis suggested a significant positive correlation between fetuin-A and eGFR. The rate of carotid artery calcification was the highest in CKD5 stage. Rank correlation analysis showed a negative correlation between fetuin-A and cIMT, and logistic regression analysis identified decreased serum Fetuin-A as a risk factor of carotid artery calcification. Conclusion Serum fetuin-A decreases following the decrease in eGFR, and decreased serum Fetuin-A level is a risk factor of carotid artery calcification in CKD patients.

关 键 词：慢性肾脏疾病 胎球蛋白A 颈动脉 钙化 肾小球滤过率 

分 类 号：R692[医药卫生—泌尿科学]