sKL、BSP与血液透析患者腹主动脉钙化和预后的关系  

Relationship between sKL, BSP and HD abdominal aortic calcification and prognosis

作　　者：许琴[1] 蔡小琴[1] 张春红[1] 危志强[1] 张锁健 丁浩[1] 曹娟[1] XU Qin;CAI Xiao-qin;ZHANG Chun-hong;WEI Zhi-qiang;ZHANG Suo-jian;DING Hao;CAO Juan(Department of Nephrology,Taixing People's Hospital,Taixing,Jiangsu 225400,China)

机构地区：[1]泰兴市人民医院肾脏内科,江苏泰兴225400

出　　处：《海南医学院学报》2020年第11期846-849,855,共5页Journal of Hainan Medical University

基　　金：江苏省卫生计生委科研项目(No.LGY201703)。

摘　　要：目的:探讨血液透析(HD)患者体内sKL、BSP表达水平与腹主动脉钙化和预后的关系。方法:选取本院收治的130例血透患者作为研究对象,采用费森尤斯血液透析机进行干预治疗,检测患者血中血清可溶性Klotho蛋白(sKL)、骨唾液酸蛋白(BSP)表达水平,随访30个月并评估患者腹主动脉钙化程度及患者预后质量,分析sKL、BSP表达水平与其腹主动脉钙化和预后的关系。结果:不同腹主动脉钙化程度患者血中sKL及BSP水平比较,差异具有统计学意义(P<0.05),其中轻度或无钙化组患者血中sKL水平最高,BSP水平最低;死亡组sKL水平明显低于存活组,BSP水平明显高于存活组,且差异具有统计学意义(P<0.05);sKL高表达患者存活率明显优于sKL低表达患者,BSP低表达存活率明显优于BSP高表达;高sKL及低BSP是影响血透患者腹主动脉钙化及预后质量的独立性保护因素(P<0.05);采用sKL及BSP联合应用在预测血透患者预后质量时敏感度及特异度均大于90%,且AUC>0.90。结论:血透患者血中高sKL及低BSP是影响腹主动脉钙化及预后质量的独立性保护因素,且sKL及BSP联合应用可有效预测患者预后质量价值。Objective:To investigate the relationship between the expression levels of sKL and BSP and the calcification and prognosis of abdominal aorta in patients with HD.Methods:Totally 130 patients with HD admitted to our hospital between January 2015 and June 2017 were selected as the research subjects;all patients were treated with Fresenius hemodialysis machine for intervention treatment;the expression levels of sKL and BSP in the patients'blood were monitored,and a follow-up study of 30 months was conducted.The extent of calcification of the abdominal aorta and the quality of the prognosis of the patients were evaluated and the relationship between the expression levels of sKL and BSP and the calcification and prognosis of the abdominal aorta were analyzed.Results:The levels of sKL and BSP in the blood of patients with different degrees of abdominal aortic calcification were significantly different(P<0.05).Among the patients with mild or no calcification,the levels of sKL and BSP were the highest in the blood and those in the death group were the lowest.The sKL level was significantly lower than the survival group,and the BSP level was significantly higher than the survival group,and the differences were statistically significant(P<0.05);the survival rate of patients with high sKL expression was significantly better than that of patients with low sKL expression,and the survival rate of low BSP expression was significantly better.High expression in BSP;high sKL and low BSP are independent protective factors affecting abdominal aortic calcification and prognostic quality in HD patients(P<0.05);the sensitivity and specificity of combined use of sKL and BSP in predicting the prognostic quality of HD patients are greater than 90%with AUC>0.90.Conclusions:High sKL and low BSP in the blood of HD patients are independent protective factors affecting abdominal aortic calcification and prognostic quality.The combined application of sKL and BSP can effectively predict the prognostic quality value of patients.

关 键 词：终末期肾病 血液透析 可溶性Klotho蛋白 唾液酸蛋白 腹主动脉钙化 预后质量 

分 类 号：R692.5[医药卫生—泌尿科学] R543.1[医药卫生—外科学]