慢性肾脏病5期非透析患者血清骨硬化蛋白与血管钙化及骨密度关系的研究  

Study on the Relationship between Serum Bone Sclerostin,Vascular Calcification and Bone Mineral Density in Patients with Chronic Kidney Disease Stage 5 Non-dialysis

作　　者：黄静 胡海英 刘春[1] HUANG Jing;HU Hai-ying;LIU Chun(Department of Nephrology,the First Affiliated Hospital of Shihezi University School of Medicine,Shihezi,Xinjiang Uygur Autonomous Region,832000 China)

机构地区：[1]新疆石河子市石河子大学医学院第一附属医院肾病科,新疆石河子832000

出　　处：《系统医学》2021年第3期55-58,共4页Systems Medicine

摘　　要：目的探讨慢性肾脏病5期(CKD5)非透析患者血清骨硬化蛋白(sclerostin)与血管钙化、骨密度及相关因素关系的研究。方法选取2018年11月—2019年8月该院收治的61例慢性肾脏病5期非透析的患者作为实验组,依据是否合并血管钙化将入选患者分为两组(A组:CKD5期无血管钙化组,B组:CKD5期血管钙化组)。选取该院同期的30名健康者作为对照组。记录入组患者的血钙、血磷、iPTH、碱性磷酸酶,用ELISA法检测血清骨硬化蛋白水平,腹部侧位X线检测腹主动脉钙化并计算其积分。双能X线片骨密度仪测量腰椎及髋部骨密度T值,比较3组血清骨硬化蛋白水平变化,探讨其与血管钙化、骨密度及各生化指标相关关系。结果B组患者血清骨硬化蛋白(82.30±21.01)pmol/L高于A组,差异有统计学意义(t=2.881,P<0.05),A组患者血清骨硬化蛋白(65.99±23.02)pmol/L高于对照组(22.75±13.90)pmol/L,差异有统计学意义(P<0.05);B组患者血清骨硬化蛋白、iPTH均高于A组,差异有统计学意义(P<0.05);B组患者骨密度T值低于A组,差异有统计学意义(P<0.05)。Pearson相关性分析显示,血清骨硬化蛋白水平与血管钙化积分、iPTH呈正相关(r=0.759、0.316,P<0.05),与骨密度呈负相关(r=-0.274,P<0.05),与血钙、血磷、AKP无显著相关。结论慢性肾脏病5期非透析患者血清骨硬化蛋白水平与血管钙化、骨密度、iPTH存在显著相关性,对预测血管钙化及骨密度降低有一定的指导意义,对未来靶向治疗血管钙化及骨质疏松提供更多的临床依据。Objective To investigate the relationship between serum bone sclerostin(sclerostin)and vascular calcification,bone mineral density and related factors in chronic kidney disease stage 5(CKD5)non-dialysis patients.Methods 61 patients with chronic kidney disease stage 5 non-dialysis patients who were admitted to the hospital from November 2018 to August 2019 were selected as the experimental group.The selected patients were divided into two groups according to whether they had vascular calcification(group A:CKD stage 5 anvascular calcification group,group B:CKD stage 5 vascular calcification group).30 healthy patients in the hospital during the same period were selected as the control group.The blood calcium,blood phosphorus,iPTH,and alkaline phosphatase of the enrolled patients were recorded.The serum sclerostin level was detected by ELISA,and the abdominal aortic calcification was detected by abdominal lateral X-ray and its integral was calculated.The dual-energy X-ray film bone densitometer measures the bone mineral density T value of the lumbar spine and hip,compares the changes of serum bone sclerostin levels in the three groups,and explores the correlation with vascular calcification,bone density and various biochemical indicators.Results The serum bone sclerostin(82.30±21.01)pmol/l of group B was higher than that of group A,the difference was statistically significant(t=2.881,P<0.05),the serum bone sclerostin of group A patients was(65.99±23.02)pmol/L,higher than the control group(22.75±13.90)pmol/L,the difference was statistically significant(P<0.05);the serum bone sclerostin and iPTH of group B were higher than those of group A,the difference was statistically significant(P<0.05);the bone mineral density T value of group B was lower than that of group A,and the difference was statistically significant(P<0.05).Pearson correlation analysis showed that serum bone sclerostin levels were positively correlated with vascular calcification score and iPTH(r=0.759,0.316,P<0.05),and negatively correlated with bone

关 键 词：慢性肾脏病 血管钙化 血清骨硬化蛋白 骨密度 

分 类 号：R692[医药卫生—泌尿科学]