肾移植患者冠状动脉钙化相关因素的探讨  

Analysis on coronary artery calcification-related factors in renal transplant recipients

作　　者：何桂芳[1] 李增磊 张欣洲[2] 陈华蓉[2] 李雄根[2] 徐坚明 HE Gui-fang;LI Zeng-lei;ZHANG Xin-zhou;CHEN Hua-rong;LI Xiong-gen;XU Jian-ming(Department of Nephrolog y,Central Hospital of Longgang,Shenzhen 518000,China;De-partment of Nephrology,Shenzhen People＇s Hospital,the Second Hospital of J inan Univer-sity,Shenzhen 518000,China)

机构地区：[1]广东省深圳市龙岗中心医院肾内科,深圳518000 [2]暨南大学第二附属医院&深圳市人民医院

出　　处：《临床肾脏病杂志》2018年第10期611-615,共5页Journal Of Clinical Nephrology

基　　金：深圳市龙岗区经济与科技发展专项基金医疗卫生科技计划项目(NO.20160607154552298)

摘　　要：目的探讨肾移植患者冠状动脉钙化的相关因素。方法对46例肾移植患者行冠状动脉多层螺旋CT(MSCT)检测,计算冠状动脉钙化(CAC)积分,同时记录血压、透析时间、移植时间,测定血清胎球蛋白A(Fetuin A)、血钙、血磷、超敏C反应蛋白(hs-CRP)等指标,将CAC积分与相关因素进行相关性分析。随访12个月后复测上述指标。结果钙化组患者(15例)与非钙化组患者(31例)在年龄、透析时间、Fetuin A、hs-CRP、低密度脂蛋白(LDL)、血钙等方面存在显著性差异(P <0. 05)。非条件Logistic回归分析显示,年龄、LDL是CAC的危险因素。CAC积分与Fetuin A呈负相关(P <0. 05),与年龄、透析时间、LDL、血钙、hs-CRP呈正相关(P <0. 05)。Fetuin A与hs-CRP、年龄存在负相关(P <0. 05)。随访12个月后有26例肾移植患者接受再次检测,CAC积分显著上升(P <0. 05)。结论肾移植并不能逆转或者抑制血管钙化的进展,高龄和LDL是肾移植患者CAC的独立危险因素,Fetuin A可能参与抑制肾移植患者的血管钙化。Objective To investigate the factors related to coronary artery calcification（CAC） in renal transplant recipients. Methods Forty-six renal transplant recipients were enrolled. CAC was detected by multislice spiral CT scan（MSCT） and quantified. Blood pressure,duration of dialysis,and duration of transplantation were recorded. Serum fetuin A,calcium,phosphonium,high-sensitive C-reactive protein（hs-CRP） and low density lipoprotein（LDL） were examined. The relationship of CAC to risk factors was analyzed. And patients were followed up and retested 12 months later. Results There were significant differences in age,duration of dialysis,serum fetuin A,hs-CRP,LDL and calcium between CAC group（15 patients） and non-CAC group（31 patients）（P〈0. 05）. Multivariable Logistic regression analysis showed that age and serum LDL were independently correlated to CAC. Serum fetuin A,LDL,hs-CRP,age and duration of dialysis in these 46 patients were related with CAC score. There was significant progression in CAC in these 26 patients who retested 12 months later（P〈0. 05）. Conclusions The trend of CAC was moving forward in renal transplant recipients. Serum fetuin A,LDL,hs-CRP,age and duration of dialysis were related with CAC score. Age and serum LDL were independently correlated to CAC.

关 键 词：冠状动脉 钙化 危险因素 肾移植 胎球蛋白A 

分 类 号：R699.2[医药卫生—泌尿科学]