维持性腹膜透析患者血清CHI3L1、HSP60与钙磷代谢、冠状动脉钙化的关系  

Relationship Between Serum CHI3L1,HSP60 and Calcium and Phosphorus Metabolism,Coronary Artery Calcification in Cases with Maintenance Peritoneal Dialysis

作　　者：张振敏[1] 李琳琳[1] 田其生[1] 刘栋[2] ZHANG Zhenmin;LI Linlin;TIAN Qisheng;LIU Dong(Nephrology Department,Zhoukou Central Hospital,Zhoukou 466000,China;Nephrology Department,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]周口市中心医院肾内科,河南周口466000 [2]郑州大学第一附属医院肾脏内科,河南郑州450000

出　　处：《河南医学研究》2024年第15期2778-2782,共5页Henan Medical Research

摘　　要：目的探讨维持性腹膜透析患者血清壳多糖酶3样蛋白1(CHI3L1)、热休克蛋白60(HSP60)与钙磷代谢、冠状动脉钙化的关系。方法选取2021年1月至2023年1月在周口市中心医院接受持续性非卧床腹膜透析或日间非卧床腹膜透析治疗>3个月的98例维持性腹膜透析患者作为研究对象,根据是否存在钙磷代谢异常分别分入钙磷正常组与钙磷异常组,根据多层螺旋CT结果参照Agatston评分法计算其冠状动脉钙化积分(CACS),将98例维持性腹膜透析患者再次分入未钙化组与钙化组,检测并对比两组患者的血清CHI3L1、血清HSP60水平。采用Pearson相关分析探讨血清CHI3L1、HSP60与钙磷代谢指标的关系,采用受试者工作特征(ROC)曲线评估血清CHI3L1、HSP60对维持性腹膜透析患者冠状动脉钙化的评估价值。通过多因素logistic逐步回归分析探讨维持性腹膜透析患者冠状动脉钙化的影响因素。结果98例维持性腹膜透析患者分为钙磷正常组(43例)、钙磷异常组(55例),钙磷代谢异常组患者血清CHI3L1、HSP60水平高于钙磷代谢正常组患者(P<0.05)。维持性腹膜透析患者血清CHI3L1、HSP60与钙磷乘积呈正相关(P<0.05)。根据多层螺旋CT结果参照Agatston评分法计算其CACS积分,将98例维持性腹膜透析患者分为未钙化组(37例)、钙化组(61例),钙化组患者血清CHI3L1、HSP60水平高于未钙化组患者(P<0.05)。血清CHI3L1、HSP60评估维持性腹膜透析患者预后的AUC分别为0.741、0.826,两者联合评估的AUC为0.915。钙化组患者低蛋白血症、高磷饮食人数及透析龄高于未钙化组(P<0.05)。多因素logistic回归分析显示:高磷饮食、透析龄、CHI3L1、HSP60是影响维持性腹膜透析患者冠状动脉钙化的危险因素(P<0.05)。结论血清CHI3L1、HSP60在钙磷代谢异常、发生冠状动脉钙化的维持性腹膜透析患者中均呈高表达,及早检测血清CHI3L1、HSP60水平有助于及时防治冠状动脉钙化�Objective To explore the relationship between serum chitinase 3-like protein 1(CHI3L1),heat shock protein 60(HSP60),calcium and phosphorus metabolism and coronary artery calcification in cases with maintenance peritoneal dialysis.Methods A total of 98 maintenance peritoneal dialysis patients who received continuous or daytime non bed rest peritoneal dialysis treatment for more than 3 months at Zhoukou Central Hospital from January 2021 to January 2023 were selected as the study subjects.According to the presence of abnormal calcium and phosphorus metabolism,they were divided into a normal calcium and phosphorus group and an abnormal calcium and phosphorus group.The coronary artery calcification score(CACS)was calculated based on the results of multi-slice spiral CT using the Agatston scoring method.The 98 maintenance peritoneal dialysis patients were further divided into an uncalcified group and a calcified group,and the serum CHI3L1 and serum HSP60 levels of the two groups were detected and compared.Pearson correlation analysis was used to explore the relationship between serum CHI3L1,HSP60 and calcium and phosphorus metabolism indicators.Receiver operating characteristic(ROC)curves were used to evaluate the value of serum CHI3L1,HSP60 in assessing coronary artery calcification in maintenance peritoneal dialysis patients.The influencing factors of coronary artery calcification in maintenance peritoneal dialysis patients was explored through multiple logistic stepwise regression analysis.Results A total of 98 maintenance peritoneal dialysis patients were divided into two groups:normal calcium and phosphorus group(43 cases)and abnormal calcium and phosphorus group(55 cases).Patients in the abnormal calcium and phosphorus metabolism group had higher serum levels of CHI3L1 and HSP60 than those in the normal calcium and phosphorus metabolism group(P<0.05).The serum CHI3L1,HSP60,and calcium phosphate product of maintenance peritoneal dialysis patients were positively correlated(P<0.05).According to the results of mult

关 键 词：维持性腹膜透析 壳多糖酶3样蛋白1 热休克蛋白60 钙磷代谢 冠状动脉钙化 

分 类 号：R457[医药卫生—治疗学]