血清铁调素25水平与腹膜透析患者冠状动脉钙化及心血管事件的关系  

Relationship between serum hepcidin-25 level with coronary artery calcification and cardiovascular events in patients with peritoneal dialysis

作　　者：黄振华[1] 冯振伟[1] 叶智明[2] 陆玲娜[1] 何坤[1] 施燕春[1] 项新[1] 李洁[1] 黄典胜[1] 

机构地区：[1]广西壮族自治区民族医院肾内科,南宁530001 [2]广东省人民医院肾内科,广州510080

出　　处：《临床肾脏病杂志》2014年第1期9-12,共4页Journal Of Clinical Nephrology

基　　金：广西自然基金资助项目（NO.2012JJAA40611）

摘　　要：目的 探讨持续性腹膜透析患者血清铁调素25（hepcidin-25）水平和冠状动脉钙化（coronary artery calcification,CAC）及心血管事件的关系.方法 选择210例持续性非卧床腹膜透析（continuous ambulatory peritoneal dialysis,CAPD）患者血清hepcidin-25的平均值为界,分为CAPD高hepcidin-25组107例、CAPD低hepcidin-25组103例;另选择在本院进行健康体检者90名作为健康对照组.通过酶联免疫法（enzyme-linked immunosorbent assay,ELISA）测定所有CAPD患者和健康对照组血清hepcidin-25水平.对所有入选者进行冠状动脉多层螺旋电子计算机断层扫描成像（multi-slice computed tomography,MSCT）钙化评价研究.结果 CAPD高hepcidin-25组在随访12个月内发生心血管事件71例次,因心血管事件死亡21例（占19.6%）;而CAPD低hepcidin-25组发生心血管事件27例次,因心血管事件死亡仅10例（占9.7%）.CAPD高hepcidin-25组和CAPD低hepcidin-25组心血管事件发生率比较,差异有统计学意义（P＜0.01）,以上2组无心血管事件生存率无统计学差异（P=0.055）.CAPD患者心血管事件发病率[46.7%（98/210）]与健康对照组心血管事件发病率[5.6%（5/90）]比较,差异有统计学意义（P＜0.01）.CAPD高hepcidin-25组CAC发病率均明显高于CAPD低hepcidin-25组（P＜0.01）;而且相关性分析显示,hepcidin-25水平与CAC积分呈正相关（r=0.980,P＜0.01）.多元逐步回归分析显示血清hepcidin-25水平[偏回归系数（B）=0.402,P＜0.01]和CAC（B=-0.015,P＜0.01）是CAPD患者心血管事件发生的重要危险因素.结论 血清hepcidin-25水平升高及CAC是CAPD患者发生心血管事件的重要原因,提示铁代谢紊乱可能参与,且促进了CAC的发生、发展,并最终导致心血管事件的发生.Objective To evaluate the relationship between serum hepcidin-25 level with coronary artery calcification （CAC） and the cardiovascular events in patients subject to continuous ambulatory peritoneal dialysis （CAPD）. Methods 210 cases of CAPD were divided into CAPD high hepcidin- 25 group （107 cases） and CAPD low hepcidin-25 group （103 cases） by the average value of serum hepcidin-25. Ninety cases in our hospital for physical examination served as healthy controls. The serum hepcidin-25 levels were determined by using enzyme-linked immunosorbent assay （ELISA）. The CAC was evaluated with multistice computed tomography （MSCT） in all patients. Results Seventy-one ca- ses of cardiovascular events occurred in CAPD high hepcidin-25 group during the follow-up peirod of 12 months, and there were 21 cases （19. 6 % ） of deaths from cardiovascular events. Twenty-seven cases of cardiovascular events occurred in CAPD low hepcidin-25-group and there were only 10 cases （9. 7 %） deaths from cardiovascular events. There was significant difference in the incidence of cardioascular events between CAPD high hepcidi-25 group and CAPD low bepcidin-25 group （P〈0.01）, and the survival rate showed no significant difference between the two groups without cardiovascular events （P = 0. 055）. There was significant difference in the incidence of cardiovascular events between CAPD group （46.7%） and health control group （5.6%） （P〈0. （1）.The incidence of CAC in CAPD high hepcidin-25 group was significantly higher than in CAPD low hepcidin-25 group （P〈0. 01）.Correlation analysis revealed that serum hepcidin-25 levels were positively correlated with CAC integration （r= 0. 980,P〈0. 980）. Multiple stepwise regression analysis indicated the serum hepcidin-25 level （B = 0. 4D2,P〈0. 01） and CAC （B= - 0. 015,P〈0. 01） are important risk factors for cardiovascular e vents in CAPD patients. ConclusionsElevated serum hepcidin-25 levels and CAC are the important reasons of CAPD p

关 键 词：腹膜透析 血清铁调素25 心血管事件 

分 类 号：R459.5[医药卫生—治疗学]