血清TNF-α及MGP水平与维持性血液透析患者心脏瓣膜钙化的关系  

Relationship of TNF-α and MGP levels with cardiac valve calcification in maintenance hemodialysis patients

作　　者：王珺 韩林子 张森[1] 王德光[1] Wang Jun;Han Linzi;Zhang Sen(Dept of Nephrology,The Second Affiliated Hospital of Anhui Medical University,Hefei 230601)

机构地区：[1]安徽医科大学第二附属医院肾脏内科,合肥230601

出　　处：《安徽医科大学学报》2018年第10期1584-1588,共5页Acta Universitatis Medicinalis Anhui

基　　金：安徽省自然科学基金(编号:1508085MH148)

摘　　要：目的探讨血清肿瘤坏死因子(TNF-α)及基质Gla蛋白(MGP)水平与维持性血液透析(MHD)患者心脏瓣膜钙化(CVC)的关系。方法纳入MHD患者66例及年龄、性别相匹配的健康人群31例,采用ELISA法检测血清TNF-α及MGP水平。超声心动图检测受试者是否伴有CVC。结果与对照组比较,MHD患者血清TNF-α升高,MGP降低,且CVC发生率明显增高(P均<0.001);在MHD患者中,CVC组血清TNF-α明显较高(P<0.05)而MGP较低(P<0.01);另外,血清MGP水平与年龄、血清碱性磷酸酶、TNF-α均呈负相关性(P均<0.05);多因素Logistic回归分析显示,透析龄和高血清TNF-α是CVC的独立危险因素(P<0.05,P<0.01),高血清MGP是CVC的保护因素(P<0.05)。结论血清TNF-α及MGP水平与MHD患者心脏瓣膜钙化密切相关,TNF-α同透析龄一样,为CVC发生的独立危险因素,MGP为其保护因素。Objective To investigate the effect of serum tumor necrosis factor-α(TNF-α)and matrix Gla protein(MGP)levels on cardiac valve calcification(CVC)in patients with maintenance hemodialysis(MHD).Methods Serum levels of TNF-αand MGP were measured by enzyme linked immunosorbent assay(ELISA)using plasma samples from 66 MHD patients and 31 healthy subjects.CVC in these subjects were examined by echocardiography.Results Serum TNF-αwere higher in MHD patients,while MGP levels were lower than those of controls and the occurrence rate of CVC was significantly increased(all P<0.001).In MHD patients,serum TNF-αlevels were significantly higher and MGP levels were significantly lower in CVC group.In addition,serum MGP levels were inversely correlated with age,serum alkaline phosphatase and TNF-α(all P<0.05).Multiple logistic regression analysis revealed that dialysis duration andhigher serum TNF-αwere independent risk factors for CVC(P<0.05,P<0.01),while higher serum MGP level was a protective factor for CVC(P<0.05).Conclusion Serum TNF-αand MGP levels are closely related to cardiac valve calcification in patients with MHD.Just lisk dialysis duration,TNF-αis an independent risk factor for CVC,while MGP is a protective factor.

关 键 词：血液透析 TNF-Α MGP 心脏瓣膜钙化 

分 类 号：R692.5[医药卫生—泌尿科学]