血清BAP、AngⅡ与尿毒症腹膜透析治疗转归的关系研究  

Study on relationship between serum bone specific alkaline phosphatase,angiotensin I and outcome of peritoneal dialysis in the treatment of uremia

作　　者：姜姣姣 汪正翔 董雄军[1] 杨静 Jiang Jiaojiao;Wang Zhengxiang;Dong Xiongjun;Yang Jing(Department of Nephrology,Wuhu Second People's Hospital,Wuhu 241000,China;School of Clinical Medicine,Anhui Medical University,Hefei 230032,China)

机构地区：[1]安徽省芜湖市第二人民医院肾内科,芜湖241000 [2]安徽医科大学临床医学院,合肥230032

出　　处：《国际泌尿系统杂志》2023年第6期1107-1112,共6页International Journal of Urology and Nephrology

基　　金：安徽省教育厅高校自然科学研究重点项目(KJ2020A0219)。

摘　　要：目的观察尿毒症腹膜透析(PD)的治疗转归情况, 并分析血清骨特异性碱性磷酸酶(BAP)、血管紧张素Ⅱ(Ang Ⅱ)与患者治疗转归的关系。方法收集2015年1月至2020年1月在本院接受PD治疗且完成随访的150例尿毒症患者的临床资料, 根据腹膜平衡实验结果确定腹膜透析治疗患者的转归情况, 并将腹膜平衡试验结果为高平均转运、低平均转运患者纳入转归良好组(115例), 其余患者纳入转归不良组(35例)。记录并分析两组患者的一般资料, 检测患者在接受PD治疗当天早晨的血清单核细胞趋化蛋白1(MCP-1)、C-反应蛋白(CRP)、BAP、AngⅡ水平, 分析血清BAP、AngⅡ表达与尿毒症PD治疗转归的关系。结果治疗后转归不良的患者有35例, 转归不良率为23.33%;转归不良组的血清MCP-1、CRP、BAP、AngⅡ水平均高于转归良好组(均P<0.05);回归分析结果显示, 血清MCP-1、CRP、BAP、AngⅡ过表达与尿毒症PD治疗患者的转归不良有关(OR>1, 均P<0.05);绘制受试者工作特征(ROC)曲线, 结果显示, 血清BAP、AngⅡ水平单独及联合预测尿毒症PD治疗患者转归不良的曲线下面积(AUC)>0.80, 预测价值较理想, 且当血清BAP、AngⅡ的Cut-off值分别取24.140 μg/L、103.200 pg/mL时, 联合预测价值最佳。结论尿毒症患者经PD治疗后的转归不良可能与治疗前血清BAP、AngⅡ过表达有关。Objective To observe the outcome of peritoneal dialysis(PD)in the treatment of uremia,and to analyze the relationship between serum bone specific alkaline phosphatase(BAP),angiotensinⅡ(AngⅡ)and the treatment outcome of patients.Methods The data of 150 patients with uremia who received PD treatment in the hospital and completed follow-up from January 2015 to January 2020 were collected.The outcomes of patients treated with peritoneal dialysis were determined according to the results of peritoneal balance test,and patients with high and low mean peritoneal balance test results were included in the good outcome group,and the other patients were included in the poor outcome group.The general data of the two groups of patients were investigated,and the levels of serum monocyte chemotactic protein 1(MCP-1),C-reactive protein(CRP),BAP and AngⅡof the patients in the morning of PD treatment were analyzed,and the relationship between the expression of serum BAP and AngⅡand the outcome of PD treatment in uremia was analyzed.Results There were 35 patients with poor outcome after treatment,and the outcome rate was 23.33%.The levels of serum MCP-1,CRP,BAP and AngⅡin the poor outcome group were higher than those in the good outcome group(all P<0.05).The results of regression analysis showed that the overexpression of serum MCP-1,CRP,BAP and AngⅡwas associated with the adverse outcome of uremic PD treatment(OR>1,all P<0.05).Receiver operating characteristic(ROC)curve was drawn,and the results showed that the area under the curve(AUC)of serum BAP and AngⅡlevels alone and in combination predicted the adverse outcome of patients treated with uremic PD was greater than O.80,and the predictive value was ideal.When the Cut-off values of serum BAP and AngⅡwere 24.140μg/L and 103.200 pg/mL,respectively,the combined prediction value was the best.Conclusions The poor outcome of patients with uremia treated with PD may be related to the overexpression of serum BAP and Ang II before treatment.

关 键 词：尿毒症 腹膜透析 血管紧张素Ⅱ 骨特异性碱性磷酸酶 

分 类 号：R692.5[医药卫生—泌尿科学]