慢性肾脏病患者血清脂联素与冠状动脉钙化积分关系的研究  

Study of the relation between serum adiponectin and coronary artery calcification score in patients with chronic kidney disease

作　　者：王英[1] 孙懿[1] 程浩[1] 贾艳丽[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：《中国医师进修杂志》2015年第10期717-720,共4页Chinese Journal of Postgraduates of Medicine

基　　金：首都医学发展科研基金（2009-3195）

摘　　要：目的探讨慢性肾脏病患者血清脂联素与冠状动脉钙化的关系，分析影响慢性肾脏病患者冠状动脉钙化的危险因素。方法选择慢性肾脏病3～5期患者29例，采用酶联免疫吸附方法测定血清脂联素，64排螺旋CT扫描心脏计算冠状动脉钙化积分（CACS），同时检测血钙、磷、全段甲状旁腺激素、总胆固醇、低密度脂蛋白胆固醇、白蛋白、尿素氮、肌酐、尿酸和高敏C反应蛋白等，计算钙磷乘积和估计肾小球滤过率。结果29例慢性肾脏病患者中，24例（83％）存在不同程度的冠状动脉钙化（CACS〉0分），CACS平均508（0～3363）分。CACS≥100分（15例）与CACS〈100分（14例）的慢性肾脏病患者的收缩压[（146．00±13．00）、（123．00±9．00）mmHg（1mmHg=0．133kPa）]、血尿素氮[（15．44±8．36）、（9．71±2．52）mmol/L]、估计肾小球滤过率[（21．77±11．81）、（38．71±11．56）ml／（min·1．73m^2）]比较差异有统计学意义（P〈0．01或〈0．05）。Pearson相关分析显示，CACS与收缩压、肌酐和尿酸呈正相关，与白蛋白和估计肾小球滤过率呈负相关。多元逐步回归分析显示收缩压和估计肾小球滤过率是CACS的独立危险因素。结论慢性肾脏病3～5期患者冠状动脉钙化严重，收缩压和估计肾小球滤过率是冠状动脉钙化的独立危险因素。Objective To investigate the relation between serum adiponectin and coronary artery calcification score （CACS）, and find the risk factors for CACS in patients with chronic kidney disease （CKD）. Methods Twenty-nine patients with 3 - 5 stage CKD were selected. The serum adiponeetin was measured by enzyme linked immunosorbent assay. The heart was scanned by 64-row spiral CT, and the CACS was calculated. The blood calcium, phosphorus, intact parathyroid hormone, total cholesterol, low density lipoprotein cholesterol, albumin, urea nitrogen, ereatinine, uric acid and high sensitive C reactive protein levels were measured, and the calcium-phosphorus product and estimation glomerular filtration rate were calculated. Results In 29 patients with CKD, 24 cases （83%） had coronary artery calcification with different degree （CACS 〉 0 score）, and the average CACS was 508 （0 - 3 363） scores. There were statistical differences in systolic blood pressure, urea nitrogen and estimation glomerular filtration rate between CKD patients with CACS≥ 100 scores （15 cases） and CKD patients with CACS 〈 100 scores （14 cases）： （146.00 ± 13.00） mmHg （1 mmHg = 0.133 kPa） vs. （123.00 ± 9.00） mmHg, （15.44± 8.36） mmol/L vs. （9.71 ±2.52） mmol/L and （21.77 ±11.81） ml/ （min·1.73 m^2） vs. （38.71 ± 11.56） ml/ （min·1.73 m^2）, P〈0.01 or 〈0.05. Pearson correlation analysis results showed that CACS had positive correlation with systolic blood pressure, creatinine and uric acid, and negative correlation with albumin and estimation glomerular filtration rate. Muh-stepwise regression analysis results showed that systolic blood pressure and estimation glomerular filtration rate were the independent risk factors of CACS. Conclusions The patients with 3 -5 stage CKD have severe coronary artery calcification. The systolic blood pressure and estimation glomerular filtration rate are the independent risk factors of coronary artery calcification.

关 键 词：肾病 脂联素 危险因素 冠状动脉钙化 

分 类 号：R692[医药卫生—泌尿科学]