血清VASH-1、SFRP4水平与血液透析患者自体动静脉内瘘狭窄的关系  

Correlation of Serum VASH-1 and SFRP4 levels with autologous arteriovenous fistula stenosis in hemodialysis patients

作　　者：罗雁归 朱小静 张爱红 贾丽娜[2] 吕文璐 倚金金 许婉婷 Luo Yangui;Zhu Xiaojing;Zhang Aihong;Jia Lina;Lyu Wenlu;Yi Jinjin;Xu Wanting(Blood Purification Center,Xi'an People's Hospital/Xi'an Fourth Hospital,Xi'an 710004,China;Department of Kidney Transplantation,First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710065,China)

机构地区：[1]西安市人民医院/西安市第四医院血液净化中心,西安710004 [2]西安交通大学第一附属医院肾移植科,西安710065

出　　处：《保健医学研究与实践》2024年第7期40-45,共6页Health Medicine Research and Practice

基　　金：陕西省科学研发计划项目(2023SF-213)。

摘　　要：目的探讨血清血管生成抑制蛋白-1(VASH-1)、分泌型卷曲相关蛋白4(SFRP4)水平与血液透析患者自体动静脉内瘘狭窄的关系,以期为预测血液透析患者自体动静脉内瘘狭窄的发生风险提供参考。方法选取2020年12月—2023年12月在西安市人民医院进行血液透析治疗的189例患者作为研究组,并根据自体动静脉内瘘发生狭窄情况分为内瘘狭窄组(65例)和内瘘非狭窄组(124例)。另选取同期体检健康者145例作为对照组。所有纳入对象于入院后24 h内采用酶联免疫吸附法检测血清VASH-1、SFRP4水平并进行组间比较。采用受试者工作特征曲线(ROC)分析血清VASH-1、SFRP4对血液透析患者自体动静脉内瘘狭窄的诊断价值,采用二分类logistic逐步回归分析影响血液透析患者自体动静脉内瘘狭窄的因素。结果研究组研究对象血清C反应蛋白(CRP)、纤维蛋白原(FIB)、SFRP4水平均高于对照组,VASH-1水平低于对照组,差异均有统计学意义(P<0.05);2组研究对象性别构成、年龄、身体质量指数(BMI)、吸烟史比例、高血压史比例、糖尿病史比例及低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血红蛋白(Hb)、血钙(Ca)、血磷(P)水平比较,差异均无统计学意义(P>0.05)。内瘘狭窄组与内瘘非狭窄组患者LDL-C、HDL-C、Hb、Ca及P水平比较,差异均无统计学意义(P>0.05);内瘘狭窄组患者血清CRP、FIB、SFRP4水平均高于内瘘非狭窄组,VASH-1水平低于内瘘非狭窄组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,血清VASH-1和SFRP4诊断血液透析患者自体动静脉内瘘狭窄的曲线下面积(AUC)为0.848(95%CI:0.798~0.898)和0.851(95%CI:0.801~0.901);血清VASH-1联合SFRP4诊断血液透析患者自体动静脉内瘘狭窄的AUC为0.921(95%CI:0.871~0.971)。logistic回归分析结果显示,血清CRP>25.25 mg/L(OR=1.950,95%CI:1.357~2.803)、VASH-1≤315.25 ng/L(OR=3.404,95%CI:1.932~5.998)、SFRP4>157.63μg/Objective To investigate the relationship between serum levels of vasohibin 1(VASH-1)and secreted frizzled-related protein 4(SFRP4)and the stenosis of autologous arteriovenous fistula(AVF)in hemodialysis patients,aiming to provide a reference for predicting the risk of AVF stenosis in hemodialysis patients.Methods A total of 189 hemodialysis patients treated at Xi'an People's Hospital from December 2020 to December 2023 were selected as the study group and divided into AVF stenosis group(n=65)and non-stenosis group(n=124)based on the occurrence of AVF stenosis.Additionally,145 healthy individuals who underwent physical examination during the same period were selected as the control group.Serum levels of VASH-1 and SFRP4 were detected by enzyme-linked immunosorbent assay within 24 hours after admission for all included participants and compared between groups.The diagnostic value of serum VASH-1 and SFRP4 for AVF stenosis in hemodialysis patients was analyzed using the receiver operating characteristic(ROC)curve,and the factors influencing AVF stenosis in hemodialysis patients were analyzed using binary logistic stepwise regression analysis.Results The levels of serum C-reactive protein(CRP),fibrinogen(FIB),and SFRP4 in the study group were significantly higher than those in the control group,while the level of VASH-1 was significantly lower than that in the control group(P<0.05).No statistically significant differences were noted in the composition of gender,age,body mass index(BMI),smoking history,history of hypertension,history of diabetes,and levels of low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),hemoglobin(Hb),blood calcium(Ca),and blood phosphorus(P)between the two groups(P>0.05).No statistically significant differences were observed in the levels of LDL-C,HDL-C,Hb,Ca,and P between the AVF stenosis group and the non-stenosis group(P>0.05);however,the levels of serum CRP,FIB,and SFRP4 in the AVF stenosis group were significantly higher than those in the non-stenosis g

关 键 词：血管生成抑制蛋白-1 分泌型卷曲相关蛋白4 血液透析 自体动静脉内瘘狭窄 危险因素 诊断价值 

分 类 号：R318.16[医药卫生—生物医学工程]