血液透析患者血清骨调素和甲状旁腺素水平的相关性  

Association between osteopontin and intact parathyroid hormone in maintenance hemodialysis patients

作　　者：张坤英[1] 刘惠兰[1] 段晓峰[1] 李国刚[1] 

机构地区：[1]首都医科大学附属复兴医院肾内科,北京100038

出　　处：《中华肾脏病杂志》2013年第11期812-817,共6页Chinese Journal of Nephrology

摘　　要：目的通过测定维持性血液透析（MHD）患者血清骨调素（OPN）和全段甲状旁腺素（iPTH）水平并分析其相关性，探讨二者在血液透析患者颈动脉钙化发生发展中的作用。方法选取稳定透析的MHD患者共48例和健康对照28例为研究对象。抽取外周血，酶联免疫吸附法（ELISA）测定血清OPN水平，同时检测血清iPTH、颈总动脉分叉处钙化斑块数目及相关临床参数，收集基线资料。对OPN与iPTH及相关参数进行相关和回归分析。结果MHD组透析前血OPN水平f（137．4±80．8）ng／L比（31．6±6．7）ng／L，P〈0．01】和iPTH水平f（456．4±326．4）μg／L比（66．9±19．3）ng／L，P〈0．01较健康对照组高；MHD组颈动脉分又处钙化斑块数目也较对照组高（P〈0．01）。MHD组透前血OPN和iPTH水平呈正相关（r=0．620，P〈0．01）。按颈动脉分叉处钙化斑块数目将患者三等分，钙化斑块数目越多的患者，血清OPN、iPTH水平越高。多元线性回归分析校正各种混杂因素后，OPN仍与iPTH呈正相关够=0．468，95％CI（0．036，0．195），t=2．936，P=0．005]。结论血液透析患者普遍存在OPN和iPTH水平升高，且OPN和iPTH水平呈正相关，二者均和颈总动脉分叉处钙化斑块数目密切相关。提示OPN和iPTH相互影响，共同参与了颈动脉钙化的发生发展过程。Objective To explore possible associations between osteopontin（OPN） and intact parathyroid hormone（iPTH）, to investigate effects of them on the progression of carotid artery calcification in patients receiving long- term hemodialysis. Methods Forty- eight maintenance hemodialysis （MHD） patients and 28 age- and sex- matched healthy volunteers were recruited. The concentration of OPN in peripheral blood was determined by enzyme linked immunosorbent assay （ELISA）. Levels of iPTH and presence of plaques in the common carotid arteries were also measured. The demographics were recorded. Results Compared with controls, levels of OPN[（137.4±80.8） ng/L vs （31.6±6.7） ng/L, P 〈 0.01] and iPTH[（456.4±326.4） ng/L vs （66.9±19.3） ng/L, P 〈 0.01] were higher in MHD patients before hemodialysis, the numbers of caleific plaques in the common carotid arteries were increased in MHD patients （P 〈 0.01）. There was a positive correlation between pre-dialysis OPN levels and iPTH levels （r = 0.620, P 〈 0.01） in MHD patients. Higher levels of OPN and iPTH correlated with greater numbers of calcific plaques in the common carotid arteries after division into three subgroups of MHD patients based on caleific plaques. In multiple linear regression analysis, the correlation between the pre- dialysis OPN and iPTH levels remained the same even if adjusting for confounding effects[ = 0.468, 95%CI （0.036, 0.195）, t = 2.936, P = 0.005]. Conclusion OPN level is positively correlated with iPTH level in hemodialysis patients, which suggesting that both of them play important roles in the progression of carotid artery calcification.

关 键 词：血液透析 骨调素 甲状旁腺素 颈动脉疾病 

分 类 号：R459.5[医药卫生—治疗学]