血清AOPP及s(P)RR与维持性血液透析患者心血管疾病及预后的关系  

The relationship between serum AOPP and s(P)RR and cardiovascular disease and prognosis in maintenance hemodialysis patients

作　　者：谢谋进 李玫[1] 张炫 杨媛[1] XIE Moujin;LI Mei;ZHANG Xuan;YANG Yuan(Department of Renal Rheumatology,Guizhou Aerospace Hospital,Zunyi,Guizhou 563000,China)

机构地区：[1]贵州航天医院肾脏风湿科,贵州遵义563000

出　　处：《国际检验医学杂志》2023年第22期2773-2778,共6页International Journal of Laboratory Medicine

基　　金：遵义市科技计划项目[遵市科合HZ字(2019)219号]。

摘　　要：目的研究维持性血液透析(MHD)患者血清晚期氧化蛋白终末产物(AOPP),分泌型前肾素受体[s(P)RR]与心血管疾病(CVD)及预后的关系。方法选取2016年1月至2018年1月期间在该院诊治的89例MHD患者为研究对象,根据随访中是否发生CVD,分为CVD组(n=39)和非CVD(NCVD)组(n=50),以同期健康体检的50例体检健康者为对照组。酶联免疫吸附试验检测血清AOPP、s(P)RR水平。多因素Logistic回归分析影响MHD患者CVD发生的因素。随访5年,随访内容为患者随访期间CVD发生情况,死亡情况及生存时间。Kaplan-Meier生存分析结果,不同血清AOPP、s(P)RR表达水平对MHD患者生存预后的影响。单因素及多因素COX回归分析影响MHD患者死亡预后的因素。结果MHD组患者血清AOPP、s(P)RR分别为(65.89±17.53)μg/L、(29.40±5.52)ng/L,明显高于对照组(13.04±3.15)μg/L、(19.21±3.31)ng/L,差异具有统计学意义(t=21.095,11.896,均P<0.05)。透析龄、C反应蛋白(CRP)、AOPP、s(P)RR是影响MHD患者CVD发生的独立因素。89例MHD患者随访过程中,死亡27例。AOPP高表达组和低表达组平均生存时间分别为(52.52±3.46)个月、(55.23±4.07)个月。s(P)RR高表达组和低表达组平均生存时间为(51.20±4.26)个月、(55.68±3.35)个月。Kaplan-Meier生存分析结果,AOPP高表达组患者累积生存明显低于AOPP低表达组,差异有统计学意义(Log-Rankχ^(2)=8.358,P=0.004),s(P)RR高表达组患者累积生存明显低于s(P)RR低表达组,差异有统计学意义(Log-Rankχ^(2)=9.036,P=0.002)。单因素及多因素COX回归分析结果透析龄、清蛋白、AOPP、s(P)RR是影响MHD患者CVD死亡预后的独立危险因素。结论MHD患者血清AOPP、s(P)RR水平升高,血清AOPP、s(P)RR高表达MHD患者生存预后较差,是影响MHD患者CVD发生及CVD死亡预后的独立危险因素。Objective To study the relationship between serum advanced oxidation protein end products(AOPP),secretory prorenin receptor[s(P)RR]and cardiovascular disease(CVD),prognosis in patients with maintenance hemodialysis(MHD).Methods Eighty nine MHD patients who were diagnosed and treated in the hospital from January 2016 to January 2018 were selected as the study subjects.Based on whether CVD occurred during follow-up,they were divided into a CVD group(n=39)and a non CVD(NCVD)group(n=50),with 50 physical examination healthy individuals who underwent physical examinations during the same period as the control group.Enzyme linked immunosorbent assay was used to detect serum expression levels of AOPP and s(P)RR.Multivariate logistic regression analysis was conducted to identify the factors that affect the occurrence of CVD in MHD patients.Follow up for 5 years,covering the occurrence of CVD,mortality,and survival time of the patient during the follow-up period.Kaplan-Meier survival analysis of the impact of different serum expression levels of AOPP,s(P)RR on the survival prognosis of MHD patients.Univariate and multivariate COX regression analysis of factors affecting the prognosis of death in MHD patients.Results The serum AOPP and s(P)RR of MHD group were(65.89±17.53)μgG/L,(29.40±5.52)ng/L,significantly higher than the control group(13.04±3.15)μg/L,(19.21±3.31)ng/L,and the differences were statistically significant(t=21.095,11.896,both P<0.05).Dialysis age,C-reactive protein(CRP),AOPP,s(P)RR were independent factors affecting CVD in MHD patients.During the follow-up of 89 MHD patients,27 died.The average survival time of AOPP high and low expression group was(52.52±3.46)months,(55.23±4.07)months.The average survival time of the high and low expression group of s(P)RR was(51.20±4.26)months,(55.68±3.35)months.Kaplan-Meier survival analysis showed that the cumulative survival of patients with high AOPP expression was significantly lower than that of patients with low AOPP expression(Log-Rankχ^(2)=8.358,P=0.004)

关 键 词：维持性血液透析 尿毒症 心血管疾病 晚期氧化蛋白终末产物 分泌型前肾素受体 

分 类 号：R692.5[医药卫生—泌尿科学]