维持性血液透析患者心脏瓣膜钙化与血清脂蛋白相关磷脂酶A2的关系  

Relationship between serum lipoprotein-associated phospholipase 2 and cardiac valve calcification in patients with maintenance hemodialysis

作　　者：陆飞 沈雷 沈雁君 黄力 袁卫东 LU Fei;SHEN Lei;SHEN Yanjun;HUANG Li;YUAN Weidong(Department of Nephrology,Nantong Haimen People′s Hospital,Jiangsu 226100)

机构地区：[1]南通市海门区人民医院肾脏内科,江苏226100

出　　处：《南通大学学报（医学版）》2024年第3期253-256,共4页Journal of Nantong University(Medical sciences)

基　　金：南通市社会民生科技计划项目(MS22021031)。

摘　　要：目的:探讨血清脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase 2,Lp-PLA2)水平与维持性血液透析(maintenance hemodialysis,MHD)患者心脏瓣膜钙化(cardiac valve calcification,CVC)的关系。方法:随机抽取MHD患者100例,根据心脏彩色多普勒超声检查评估患者是否发生CVC分为CVC组(44例)与非CVC组(56例)。比较两组临床特征及实验室指标,采用多因素Logistic回归分析CVC发生的影响因素,绘制ROC曲线分析Lp-PLA2对CVC的预测价值。结果:100例MHD患者中的CVC发病率为44%;CVC组年龄、透析龄、血清Lp-PLA2水平均高于非CVC组(均P<0.05)。多因素Logistic回归分析结果显示,高龄、透析龄长、血清Lp-PLA2升高是MHD患者发生CVC的独立危险因素(P<0.05)。ROC曲线显示,Lp-PLA2预测MHD患者发生CVC的AUC为0.840(P<0.05),具有较高的预测价值。结论:血清Lp-PLA2升高是MHD患者发生CVC的危险因素,可能成为预测MHD患者CVC发生的重要生物学标志物。Objective:To evaluate the potential association of serum lipoprotein-associated phospholipase 2(Lp-PLA2)with the development of cardiac valve calcification(CVC)in maintenance hemodialysis(MHD)patients.Methods:A total of 100 MHD patients were divided into two groups,CVC group(44 cases)and non-CVC(56 cases)according to cardiac color Doppler ultrasound examination.The clinical characteristics and laboratory indexes were compared between the two groups.Multivariate Logistic regression analysis was used to analyze the influencing factors of CVC occurrence,and ROC curve was drawn to analyze predictive value of Lp-PLA2 on CVC.Results:The prevalence of CVC in 100 MHD patients was 44%.Mean age,dialysis duration and serum Lp-PLA2 were higher in CVC group than those in non-CVC group(P<0.05).Multivariate Logistic regression analysis showed that old age,long dialysis duration and increased serum Lp-PLA2 were independent risk factors for CVC in MHD patients.The ROC curve showed that the AUC of Lp-PLA2 predicting CVC in MHD patients was 0.840(P<0.05),which has high predictive value.Conclusion:Increased serum Lp-PLA2 was the risk factor for CVC in MHD patients,it may become an important biological marker for predicting the occurrence of CVC in MHD patients.

关 键 词：维持性血液透析 脂蛋白相关磷脂酶A2 心脏瓣膜钙化 

分 类 号：R459.5[医药卫生—治疗学]