硫代硫酸钠治疗尿毒症钙化的效果及对血清钙化因子、miR-21和miR-125b的影响  

Effect of sodium thiosulfate on uremic calcification and its influence on serum calcification factors,miR-21 and miR-125b

作　　者：梁辑 郑颖来 王华 詹元英 LIANG Ji;ZHENG Ying-lai;WANG Hua(Department of Nephrology,Haikou Third People's Hospital,Haikou Hainan 571100,China)

机构地区：[1]海口市第三人民医院肾内科,海南海口571100

出　　处：《临床和实验医学杂志》2023年第24期2612-2617,共6页Journal of Clinical and Experimental Medicine

基　　金：2019年海南省自然科学基金面上项目(编号:820MS165)。

摘　　要：目的探究硫代硫酸钠(STS)治疗尿毒症钙化的效果及对血清钙化因子、微小RNA(miR)-21和miR-125b的影响。方法前瞻性选取2020年12月至2022年12月于海口市第三人民医院就诊的102例终末期肾病(ESRD)合并冠状动脉钙化(CAC)患者作为研究对象,按照随机数字表法将其分为研究组(n=51)和对照组(n=51)。对照组进行常规治疗,研究组在对照组的基础上联合STS静脉注射。比较两组患者治疗前后血管钙化指标[冠状动脉钙化(CAC)评分、心踝血管指数(CAVI)],钙磷代谢指标[血钙、血磷、钙磷乘积、甲状旁腺激素(PTH)],骨钙代谢指标[成纤维细胞生长因子23(FGF23)、骨形成蛋白(BMP-2)和骨碱性磷酸酶(bALP)],炎症因子指标[C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]以及外周血miR-21、miR-125b表达水平变化,统计治疗期间不良反应发生情况。结果治疗3个月后,两组CAC评分、CAVI均下降,且研究组CAC评分、CAVI分别为(101.34±10.64)分、8.64±1.24,均低于对照组[(124.24±12.48)分、10.01±1.22],差异均有统计学意义(P<0.05)。治疗3个月后,两组血清钙、血清磷、钙磷乘积和iPTH水平均较治疗前下降,且研究组血清钙、血清磷、钙磷乘积和iPTH水平分别为(2.01±0.34)mmoL/L、(1.94±0.22)mmoL/L、(3.91±0.35)mmoL/L、(3.42±0.34)ng/mL,均低于对照组[(2.16±0.38)mmoL/L、(2.23±0.27)mmoL/L、(4.92±0.43)mmoL/L、(4.74±0.41)ng/mL],差异均有统计学意义(P<0.05)。治疗3个月后,两组FGF23、BMP-2、bALP、hs-CRP、IL-6和TNF-α水平均较治疗前下降,且研究组FGF23、BMP-2、bALP、hs-CRP、IL-6和TNF-α水平分别为(208.41±34.84)pg/mL、(81.35±9.23)ng/L、(9.34±2.87)IU/L、(6.31±2.21)mg/L、(92.36±10.27)ng/L、(29.81±4.14)pg/mL,均低于对照组[(242.32±38.34)pg/mL、(90.48±10.31)ng/L、(14.54±3.47)IU/L、(10.29±3.34)mg/L、(101.44±12.14)ng/L、(37.59±4.76)pg/mL],差异均有统计学意义(P<0.05)。治疗3个月后,两组miR-21水平Objective To explore the effect of sodium thiosulfate(STS)in the treatment of uremic calcification and its influence on serum calcification factors,microRNA(miR)-21 and miR-125b.Methods A total of 102 patients with end-stage renal disease(ESRD)complicated with coronary artery calcification(CAC)treated in Haikou Third People's Hospital from December 2020 to December 2022 were prospectively selected as study subjects,and divided into study group(n=51)and control group(n=51)according to the random number table method.The control group received conventional treatment,and the study group was given STS intravenous injection on the basis of the control group.Vascular calcification indicators[coronary artery calcification(CAC)score,cardio-ankle vascular index(CAVI)],calcium-phosphorus metabolism indicators[serum calcium,serum phosphorus,calcium-phosphorus product,parathyroid hormone(PTH)],bone calcium metabolism indicators[fibroblast growth factor 23(FGF23),bone morphogenetic protein(BMP-2),bone alkaline phosphatase(bALP)],inflammatory factors[C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]and expression levels of peripheral blood miR-21 and miR-125b were compared between the two groups before and after treatment,and the adverse reactions during treatment were counted.Results After 3 months of treatment,the CAC score and CAVI of two groups were lower than those before treatment,and the CAC score and CAVI of the study group were(101.34±10.64)points and 8.64±1.24,respectively,which were lower than those of the control group[(124.24±12.48)points and 10.01±1.22],the differences were statistically significant(P<0.05).After 3 months of treatment,the levels of serum calcium,serum phosphorus,calcium phosphorus product,and iPTH in two groups were lower than those before treatment,and the levels of serum calcium,serum phosphorus,calcium phosphorus product,and iPTH in the study group were(2.01±0.34)mmoL/L,(1.94±0.22)mmoL/L,(3.91±0.35)mmoL/L,and(3.42±0.34)ng/mL,respectively,which were lower t

关 键 词：微小RNA 终末期肾病 血管钙化 冠状动脉钙化 硫代硫酸钠 

分 类 号：R692.5[医药卫生—泌尿科学]