维持性血液透析患者血清骨硬化蛋白水平与矿物质代谢紊乱、骨病变和腹主动脉钙化的相关性  

Association of serum osteosclerosis protein level with mineral metabolic disorders,bone lesions and abdominal aortic calcification in patients with maintenance hemodialysis

作　　者：侯晶晶[1] 王莉华[1] 高永宁[1] 申磊[1] 赵海华 HOU Jing-jing;WANG Li-hua;GAO Yong-ning(Department of Hemodialytics,The Second Hospital of Hebei Medical University,Shijiazhuang Hebei 050000,China)

机构地区：[1]河北医科大学第二医院血液透析科

出　　处：《临床和实验医学杂志》2019年第20期2206-2209,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省卫计委指导性科技成果推广课题(编号:20170092)

摘　　要：目的探究维持性血液透析(MHD)患者血清骨硬化蛋白水平与矿物质代谢紊乱、骨病变和腹主动脉钙化的相关性。方法回顾性选取2016年1月至2018年12月河北医科大学第二医院收治的MHD患者130例,采用酶联免疫吸附法(ELISA)检测患者血清骨硬化蛋白水平,检测患者血钙、血磷、甲状旁腺激素(IPTH)等矿物质代谢指标情况,采用超声定量法检测患者骨密度,腰椎侧位X线片检测患者腹主动脉钙化评分(Kauppila半定量法),观察MHD患者血清骨硬化蛋白水平与ACC评分以及血红蛋白(Hb)、白蛋白(Alb)、钙、磷、IPTH、25(OH)VitD等血清生化指标,并探讨其相关性。结果130例MHD患者平均年龄为(41.2±6.3)岁,平均透析时间为(42.5±9.6)个月,平均体重为(58.4±7.6)kg,平均体重指数(BMI)为(20.7±2.9)kg/m^2。患者平均血红蛋白(Hb)为(108.3±11.7)g/L,平均白蛋白(Alb)为(36.8±9.6)g/L,平均血钙浓度为(2.3±0.2)mmol/L,平均血磷(P^3+)浓度为(2.1±0.3)mmol/L,平均IPTH水平为(0.4±0.1)pg/ml,平均25羟维生素D[25(OH)VitD]为(21.3±3.8)ng/ml,平均钙磷乘积为(5.1±1.3)mmol^2/L^2。重度钙化患者骨硬化蛋白水平明显高于轻度钙化以及中度钙化患者,且ACC得分越高,患者腹主动脉钙化情况越严重,差异具有统计学意义(P<0.05)。患者血清骨硬化蛋白水平与BMI、血钙浓度(Ca^2+)以及25(OH)VitD呈正相关,与IPTH呈负相关,差异具有统计学意义(P<0.05)。结论MHD患者随着血清骨硬化蛋白水平的升高,矿物质代谢紊乱加剧,骨病变可能性增大,同时伴随腹主动脉钙化严重,血清骨硬化蛋白可作为临床判断MHD患者矿物质代谢紊乱、骨病变及血管钙化的重要因素。Objective To explore the correlation between serum osteosclerosis protein level and mineral metabolic disorders,bone lesions and abdominal aortic calcification in maintenance hemodialysis patients with maintenance hemodialysis(MHD).Methods 130 patients with MHD admitted to the second hospital of Hebei Medical University from January 2016 to December 2018 were retrospectively selected into the present study.The levels of serum osteosclerosis protein were detected by enzyme-linked immunosorbent assay ELISA(Enzyme linked immunosorbent assay),serum calcium,phosphorus,parathyroid hormone(IPTH)and other mineral metabolic indicators were detected.Ultrasound quantitative method was used to detect the patients.Bone mineral density(BMD)and abdominal aortic calcification score(Kauppila semi-quantitative method)were measured by lumbar lateral X-ray.Serum osteosclerosis protein level and ACC score,hemoglobin(Hb),albumin(Alb),calcium,phosphorus,IPTH,25(OH)VitD and other serum biochemical indicators in MHD patients were observed,and their correlation was discussed.Results The average age of 130 patients with MHD was(41.2±6.3)years,the average duration of dialysis was(42.5±9.6)months,the average dry weight of patients was(58.4±7.6)kg,and the overall BMI(Body Mass Index)index was(20.7±2.9)kg/m^2.The average hemoglobin(Hb)and albumin(Alb)were(108.3±11.7)g/L and(36.8±9.6)g/L,respectively.The average serum calcium(Ca 2+)concentration was(2.3±0.2)mmol/L,phosphorus(P^3+)concentration was(2.1±0.3)mmol/L,parathyroid hormone(IPTH)concentration was(0.4±0.1)pg/ml,25 hydroxyvitamin D[25(OH)VitD]was(21.3±3.8)ng/ml andcalcium product was(21.3±0.3)mmol/L.The average product of calcium and phosphorus is(5.1±1.3)mmol^2/L^2.The level of osteosclerosis protein in patients with severe calcification was significantly higher than that in patients with mild calcification and moderate calcification.The higher the ACC score,the more severe the abdominal aortic calcification in patients with severe calcification,the difference was statistical

关 键 词：维持性血液透析 骨硬化蛋白 矿物质代谢紊乱 骨病变 腹主动脉钙化 

分 类 号：R73[医药卫生—肿瘤]