Klotho、VEGF、BMP-7与行持续性血液透析的感染性休克合并AKI动脉钙化的相关性  

Analysis of correlation between Klotho,VEGF and BMP-7 and arterial calcification in patients with septic shock complicated with AKI undergoing continuous hemodialysis

作　　者：蔡亚琳[1] 候晶晶 高永宁[2] 赵海华 张雪宁[1] CAI Ya-in;HOU Jing-jing;GAO Yong-ning;ZHAO Hai-hua;ZHANG Xue-ning(The Second Hospital of Hebei Medical University,Shijiazhuang,Hebei 050o00,China)

机构地区：[1]河北医科大学第二医院药学部,河北石家庄050000 [2]河北医科大学第二医院血液透析,河北石家庄050000

出　　处：《中华医院感染学杂志》2023年第8期1177-1181,共5页Chinese Journal of Nosocomiology

基　　金：河北省卫健委立项课题(20230649)。

摘　　要：目的探究可溶性Klotho蛋白、血管内皮生长因子(VEGF)、骨形态发生蛋白7(BMP-7)基因与行持续性血液透析治疗感染性休克合并急性肾损伤(AKI)患者动脉钙化的相关性。方法选取2020年6月-2021年5月于河北医科大学第二医院接诊治疗的86例行持续性血液透析的感染性休克合并AKI患者,其中有动脉钙化患者44例设为钙化组,未检出动脉钙化患者42例设为非钙化组。检测Klotho、VEGF、BMP-7表达,分析Klotho、VEGF、BMP-7在感染性休克合并AKI患者动脉钙化中的表达及相关性。结果不同程度钙化患者的年龄、脉压差、血清肌酐(Scr)、尿素、血清白蛋白、血磷、iPTH比较,具有统计学差异(P<0.05);与非钙化组相比,钙化组患者血清Klotho、BMP-7表达降低,VEGF水平升高(P<0.05);与轻度钙化患者相比,中度钙化患者VEGF水平较高,Klotho、BMP-7表达较低(P<0.05);与中度钙化患者相比,重度钙化患者Klotho、BMP-7表达较低,VEGF表达较高(P<0.05);Klotho指数与VEGF呈负相关(r=-0.607,P=0.001);Klotho指数与BMP-7呈正相关(r=0.571,P=0.001);VEGF与BMP-7呈负相关(r=-0.503,P=0.001)。结论Klotho、VEGF、BMP-7水平表达与持续性血液透析的感染性休克合并AKI患者动脉钙化疾病发展密切相关,且Klotho、VEGF、BMP-7可能与动脉钙化的发生、发展存在相关性。Klotho、VEGF、BMP-7血清水平的检测对持续性血液透析的感染性休克合并AKI患者动脉钙化病情判断、预后具有一定临床价值。OBJECTIVE To investigate the correlation between soluble Klotho protein,vascular endothelial growth factor(VEGF)and bone morphogenetic protein 7(BMP-7)genes and arterial calcification in patients with septic shock complicated with acute kidney injury(AKI)undergoing continuous hemodialysis.METHODS Among 86 patients with septic shock combined with AKI treated in the Second Hospital of Hebei Medical University from Jun 2020 to May 2021,44 patients with arterial calcification were divided into the calcified group and 42 patients without detected arterial calcification were in the non-calcified group.The expression levels of Klotho,VEGF and BMP-7 were detected,and the correlation betweeen Klotho,VEGF and BMP-7 expression and arterial calcification in septic shock patients with AKI was analyzed.RESULTS There were significant differences in age,pulse pressure,serum creatinine(Scr),urea,serum albumin,serum phosphorus and iPTH among patients with different degrees of calcification(P<0.05).Compared with the non-calcified group,lower serum Klotho and BMP-7 expression in the calcified group were lower while the VEGF level was higher(P<0.05).Compared with patients with mild calcification,patients with moderate calcification had higher level of VEGF and lower expression levels of Klotho and BMP-7(P<0.05).In contrast to the patients with moderate calcification,patients with severe calcification had lower Klotho and BMP-7 expression and higher VEGF expression(P<0.05).The Klotho index was negatively correlated with the VEGF(r=-0.607,P=0.001)and positively correlated with BMP-7(r=0.571,P=0.001);VEGF was negatively correlated with BMP-7(r=-0.503,P=0.001).CONCLUSION The expression levels of Klotho,VEGF and BMP-7 are closely related to the progression of arterial calcification disease in patients with septic shock and AKI under continuous hemodialysis.Klotho,VEGF and BMP-7 may be related to the occurrence and development of arterial calcification.The detection of serum levels of Klotho,VEGF and BMP-7 has certain clinical value for th

关 键 词：可溶性Klotho蛋白 血管内皮生长因子 骨形态发生蛋白7 血液透析 感染性休克 急性肾损伤 

分 类 号：R631.4[医药卫生—外科学]