维持性血液透析30例血清骨形成蛋白7与腹主动脉钙化相关性研究  

Correlation analysis of serum bone morphogenetic protein-7 with abdominali aorta calcification in maintenance hemodialysis patients

作　　者：张琢[1] 吴雪莹[1] 徐天华[1] 杜银科[1] 王力宁[1] 姚丽[1] ZHANG Zhuo;WU Xue-ying;XU Tian-hua;DU Yin-ke;WANG Li-ning;YAO Li(Department of Nephrogy,the First Affiiated Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院肾内科,辽宁沈阳110001

出　　处：《中国实用内科杂志》2018年第12期1165-1168,共4页Chinese Journal of Practical Internal Medicine

基　　金：国家"十二五"科技支撑计划项目(2011BAI-10B02);沈阳市科学技术计划攻关项目(F16-206-9-04);卫生公益性行业科研专项(201502010)

摘　　要：目的探讨维持性血液透析(MHD)患者血清骨形成蛋白7(BMP-7)与腹主动脉钙化以及临床指标间的关系。方法选取中国医科大学附属第一医院2015年6月至2016年6月MHD患者30例,同时选取同期健康志愿者30名为对照组,收集相关人口学资料,检测血钙、血磷、血镁、血清白蛋白、全段甲状旁腺激素、25-羟维生素D3及血清BMP-7等指标。应用侧位腹部X线平片评估腹主动脉钙化情况,对钙化者以Kauppila评分标准对其评分,并对相关结果进行统计学分析。结果 MHD组腹主动脉钙化者占40%,高于对照组的6.67%,差异有统计学意义(P<0.01)。钙化积分与年龄、透析龄、血磷、钙磷乘积、血镁、全段甲状旁腺激素呈正相关(r分别为0.588,0.417,0.741,0.623,0.47和0.588,P均<0.05),与BMP-7(r=-0.796,P<0.01)呈负相关,而与其他指标无明显相关性。透析患者BMP-7显著高于对照组[(1405.75±783.13)ng/L对(93.55±51.76)ng/L,P<0.01)。血清BMP-7与年龄(r=-0.428,P=0.018)及血磷(r=-0.418,P=0.021)呈负相关。结论维持性血液透析患者发生腹主动脉钙化较正常人更普遍。血清BMP-7可能是血管钙化的保护因素。Objective To investigate the correlation between bone morphogenetic protein-7(BMP-7) level and calcification of abdominal aorta and clinical index in patients with maintenance hemodialysis(MHD).Methods Thirty patients with maintenance hemodialysis were enrolled from the First Affiliated Hospital of China Medical University,and 30 healthy volunteers were recruited as the control group.The related demographic data were collected and we tested serum calcium(Ca),phosphorus(P),magnesium(Mg),albumin(ALB),intact parathyroid hormone(iPTH),25-hydroxyvitaminD3 [25-(OH)VitD3] and BM7-7.The abdominal aorta calcification was evaluated by lateral abdominal radiograph and the scores were rating by Kauppila grading criteria.The related results were analyzed statistically.Results The rate of abdominal aorta calcification in the MHD group was 40%,which was higher than that in the control group(6.67%),and the difference was statistically significant(P<0.01).The calcification score was positively correlated with age,dialysis time,P,calcium and phosphorus product,Mg,iPTH(r=0.588,0.417,0.741,0.623,0.470 and 0.588 respectively,P< 0.05),but negatively correlated with BMP-7(r=-0.796),and not correlated with other indexes.The level of BMP-7 in dialysis patients was significantly higher than that in the control group [(1405.75 ± 783.13)ng/L vs(93.55 ± 51.76)ng/L,P <0.01].The serum BMP-7 level was negatively correlated with age(r=-0.428,P=0.018) and P(r=-0.418,P=0.021).Conclusion Vascular calcification is more common in maintenance hemodialysis patients than in normal subjects.Serum BMP-7 may be a protective factor in vascular calcification.

关 键 词：骨形成蛋白7 维持性血液透析 腹主动脉钙化 

分 类 号：R692.5[医药卫生—泌尿科学]