胎球蛋白A与腹膜透析患者左心功能的关系及对残存肾功能的影响  

Association of fetuin A, left ventricular function and residual renal function in peritoneal dialysis patients

作　　者：王泽彬[1] 梁剑波[1] 江丽屏[1] 詹俊琳[2] 

机构地区：[1]广州医科大学附属第二医院肾内科,510162 [2]广州医科大学附属第二医院儿科,510162

出　　处：《中华肾脏病杂志》2016年第6期425-429,共5页Chinese Journal of Nephrology

基　　金：广东省科技计划项目（2011B031800307）

摘　　要：目的探讨腹膜透析患者中胎球蛋白A（fetuin A）与左心功能的关系及对残存。肾功能（RRF）的影响。方法将80例新进入腹膜透析患者分成高fetuin A组及低fetuin A组，两组患者进行血红蛋白（Hb）、高敏C反应蛋白（hsCRP）、钙、磷及白蛋白、脂蛋白及彩色超声检查左心室心肌做功指数（LV-MPI）等相关临床指标的检测；随访12个月，观察两组患者的实验室指标差异及fetuin A与左心室功能的关系及对RRF的影响。结果入组时，两组患者hsCRP、钙磷水平、白蛋白、脂蛋白及LV—MPI、肾小球滤过率（eGFR）差异无统计学意义；随访12个月后，高fetuin A组患者LV—MPI（P〈0．05）明显小于低fetuin A患者，而eGFR大于低fetuin A组（P〈0．05）；与随访开始前相比，低fetuin A组患者的LV．MPI明显延长（JP〈0．05）及eGFR显著下降（P〈0．05），而高fetuin A组患者的LV-MPI及eGFR变化不明显。Pearson相关分析显示fetuin A与LV—MPI明显负相关（r=0．680，P〈0．01）；多元逐步回归分析显示eGFR与fetuin A呈正相关（B=0．058，t=3．679，P〈0．01），与MPI（B=-0．511，t=-2．903，P=0.007）、年龄（B=-0．144，t=-4．013，P〈0．01）呈负相关，糖尿病是eGFR下降的危险因素（B=-2．031，t=-2．759，P〈0．05）。结论腹膜透析患者的胎球蛋白A水平与左心功能关系密切，胎球蛋白A水平下降及左心功能下降是腹膜透析患者残存肾功能丢失的重要危险因素。Objective To investigate the relationship between fetuin A and left ventricular function and their influences on residual renal function（RRF） in peritoneal dialysis patients. Method Eighty patients recently initiating peritoneal dialysis were enrolled into this study and were divided into high fetuin A group and low fetuin A group aceordin to the value of serum fetuin A concentration. Hemoglobin, high sensitive C reactive protein（hsCRP）, calcium, phosphorus, albumin, lipoproteins and left ventrieular myocardial performance index（LV-MPI） were examined. All these patients were followed up for 12 months, to discover the parameters＇ differences between two groups and to investigate the association between fetuin A and left ventricular function and RRF. Results At the beginning of the study, there was no difference of hsCRP, calcium, phosphorus, albumin, lipoproteins and LV- MPI, estimated glomerular filtration rate （eGFR） between two groups; After 12 months follow-up, MPI was obviously shorter （P 〈 0.05） and RRF was obviously higher （P 〈 0.05） in high fetuin A group than thosein low fetuin A group. Compared with the beginning of the study, LV-MPI was significantly increased and eGFR was significantly decreased after 12 months follow-up （both P 〈 0.05） in low fetuin A group, but no obviously change of LV-MPI or eGFR was found in high fetuin A group after follow- up. Pearson correlation analysis discovered an obvious negative correlation between fetuin A and MPI （r=-0.680, P 〈 0.01）. Multiple regression analysis indicated that eGFR had positive correlation with fetuin A （B=0.058, t=3.679, P〈 0.01） and negative correlations with MPI （B=-0.511, t=-2.903, P= 0.007）, age（B=-0.144, t=-4.013, P〈 0.01）. Diabetes was risk factor to loss of RRF （B=-2.031, t=-2.759, P 〈 0.05）. Conclusion Fetuin A has very close relationship with left ventricular function. Decreased serum fetuin A level and decreased left ventricular function are risk factors to the loss of the RRF

关 键 词：腹膜透析 心室 胎球蛋白A 残存肾功能 心功能 

分 类 号：R692[医药卫生—泌尿科学]