维持性血液透析患者血清BMP-2和BMP-4水平与血管钙化的关系  

Correlations Between Serum Levels of BMP-2 and BMP-4 with Vascular Calcification in Patients Undergoing Maintenance Hemodialysis

作　　者：陈燕文 陈都 甘春蕾 罗凤枚 叶雅龙 CHEN Yan-wen;CHEN Du;GAN Chun-lei;LUO Feng-mei;YE Ya-long(Department of Nephrology,the Sixth People's Hospital of Huizhou City,Huizhou,Guangdong 516200,China)

机构地区：[1]惠州市第六人民医院肾内科,广东惠州516200

出　　处：《临床误诊误治》2021年第8期91-95,共5页Clinical Misdiagnosis & Mistherapy

基　　金：广东省医学科研基金项目(A2017474)。

摘　　要：目的探究维持性血液透析(MHD)患者血清骨形态发生蛋白-2(BMP-2)和BMP-4水平与血管钙化的关系。方法选取2017年8月—2019年7月进行MHD的慢性肾衰竭158例纳入MHD组,另选取158名体检的健康志愿者作为对照组。比较两组一般资料、血清白蛋白(ALB)、血钙、血镁、血磷、全段甲状旁腺激素(iPTH)、BMP-2、BMP-4水平及腹主动脉钙化积分(AACs)。按照AACs将MHD患者分为中、重度钙化组和无、轻度钙化组,影响MHD患者血管钙化的相关因素采用多因素Logistic回归分析,血清BMP-2、BMP-4与临床指标的相关性采用Pearson相关分析。结果MHD组iPTH、血磷、钙磷乘积、BMP-2、BMP-4、腹主动脉钙化率、AACs均高于对照组,ALB、血镁低于对照组(P<0.01)。中、重度钙化组年龄、透析龄、iPTH、血磷、血镁、钙磷乘积、BMP-2、BMP-4均高于无、轻度钙化组(P<0.01)。年龄、透析龄、BMP-2、BMP-4、钙磷乘积、iPTH均为MHD患者血管钙化的独立危险因素(P<0.05,P<0.01)。血清BMP-2、BMP-4与年龄、透析龄、血镁、血磷、钙磷乘积、iPTH、AACs呈正相关,且BMP-2与BMP-4也呈正相关(P<0.05,P<0.01)。结论MHD患者血清BMP-2、BMP-4呈高水平,可能参与血管钙化的发生,且二者升高是MHD患者发生血管钙化的危险因素。Objective To explore correlations between serum levels of bone morphogenetic protein-2(BMP-2)and BMP-4 with vascular calcification in patients undergoing maintenance hemodialysis(MHD).Methods A total of 158 chronic renal failure(CRF)patients undergoing MHD between August 2017 and July 2019 were selected as MHD group,while other 158 healthy volunteers who had undergone physical examinations were selected as control group.Differences in general informations,serum levels of albumin(ALB),blood calcium,blood magnesium,blood phosphorus,intact parathyroid hormone(iPTH),BMP-2 and BMP-4,and abdominal aortic calcification score(AACs)were compared between two groups.MHD patients were divided into moderate or severe calcification subgroup and no or mild calcification subgroup according to AACs scores.Related factors affecting vascular calcification in MHD patients were analyzed by multivariate logistic regression,and correlations between serum levels of BMP-2 and BMP-4 with clinical indicators were analyzed by Pearson correlation analysis.Results In MHD group,values of iPTH,blood phosphorus,calcium-phosphorus product,BMP-2,BMP-4,abdominal aortic calcification rate and AACs were significantly higher,while levels of ALB and blood magnesium were significantly lower than those in control group(P<0.01).Values of age,dialysis time,iPTH,blood phosphorus,blood magnesium,calcium-phosphorus product,BMP-2 and BMP-4 in moderate or severe calcification subgroup were significantly higher than those in no or mild calcification subgroup(P<0.01).Age,dialysis time,BMP-2,BMP-4,calcium-phosphorus product and iPTH were all independent risk factors for vascular calcification in MHD patients(P<0.05,P<0.01).Serum levels of BMP-2 and BMP-4 were positively correlated with age,dialysis time,blood magnesium,blood phosphorus,calcium-phosphorus product,iPTH and AACS,and BMP-2 was positively correlated with BMP-4 in MHD patients(P<0.05,P<0.01).Conclusion Serum levels of BMP-2 and BMP-4 are high in MHD patients,which may be involved in the pathogenesy of v

关 键 词：维持性血液透析 血管钙化 骨形态发生蛋白-2 骨形态发生蛋白-4 危险因素 

分 类 号：R459.5[医药卫生—治疗学]