血清铁蛋白、Cys⁃C及二者联合对维持性血液透析患者血管钙化的评估价值  

The value of serum ferritin,Cys⁃C and their combination on vascular calcification in maintenance hemodialysis

作　　者：朱沈青 王红梅 李洪玉 王燕琴 ZHU Shenqing;WANG Hongmei;LI Hongyu;WANG Yanqin(Department of Hemodialysis,Fengxian District Central Hospital,Shanghai,China,201406)

机构地区：[1]上海市奉贤区中心医院血透室,上海201406

出　　处：《分子诊断与治疗杂志》2024年第11期2161-2164,共4页Journal of Molecular Diagnostics and Therapy

基　　金：上海市科学技术委员会项目(21YE143700)。

摘　　要：目的探讨血清铁蛋白、胱抑素C(Cys⁃C)及二者联合对维持性血液透析(MHD)患者血管钙化的评估价值。方法选取2020年1月至2023年8月上海市奉贤区中心医院收治的136例MHD患者,根据是否发生血管钙化分为钙化组93例、无钙化组43例,根据血管钙化程度将钙化组分为轻度组29例、中度组46例、重度组18例。采用Pearson相关性分析探讨MHD合并血管钙化患者血清铁蛋白、Cys⁃C水平与血钙、血磷的相关性;采用受试者工作特性(ROC)曲线评估血清铁蛋白、Cys⁃C对MHD患者血管钙化的预测价值。结果钙化组透析龄大于无钙化组,血钙、血磷、铁蛋白、Cys⁃C水平高于无钙化组,差异有统计学意义(P<0.05)。血清铁蛋白、Cys⁃C水平:轻度组<中度组<重度组,差异有统计学意义(P<0.05)。Pearson相关分析显示,MHD合并血管钙化患者血清铁蛋白、Cys⁃C水平与血钙、血磷均呈正相关(P<0.05)。ROC曲线结果显示,血清铁蛋白、Cys⁃C及二者联合预测MHD患者血管钙化的曲线下面积(AUC)(95%CI)分别为0.866(0.851~0.917)、0.752(0.701~0.803)、0.901(0.850~0.952),截点值分别为272.48 ng/mL、1.54 mg/L,特异度分别为0.652、0.560、0.869,灵敏度分别为0.904、0.904、0.855。结论血清铁蛋白、Cys⁃C水平升高与MHD患者血管钙化有关,可作为MHD患者血管钙化的预测因子,且二者联合预测的效能更高。Objective To explore the value of serum ferritin,cystatin C(Cys⁃C),and their combination in evaluating vascular calcification in maintenance hemodialysis(MHD)patients.Methods 136 MHD cases in our hospital from January 2020 to August 2023 were selected.The cases were divided into a calcification group(93 cases)and a non⁃calcification group(43 cases)based on the presence of vascular calcification.Additionally,the cases were further categorized into mild(29 cases),moderate(46 cases)and severe(18 cases)groups based on the degree of vascular calcification.Pearson correlation analysis was used to explore the relationship between serum ferritin,Cys⁃C levels,blood calcium,and blood phosphorus in MHD cases with VC.The predictive value of serum ferritin and Cys⁃C for VC in MHD cases was assessed using ROC analysis.Results The age of dialysis for the calcified group is higher than that of the non⁃calcified group.Additionally,the levels of blood calcium,blood phosphorus,and ferritin in the calcified group were higher compared to the non⁃calcified group,with statistically significant differences(P<0.05).The levels of serum ferritin and Cys⁃C were found to be lower in the mild group,followed by the moderate group and the severe group,with significant differences(P<0.05).Furthermore,serum ferritin and Cys⁃C levels showed a positive correlation with serum calcium and blood phosphorus in MHD patients with vascular calcification(P<0.05).The area under the curve(AUC)(95%CI)of serum ferritin,Cys⁃C,and their combination for predicting vascular calcification in MHD patients was 0.866(0.851~0.917),0.752(0.701~0.803),and 0.901(0.850⁃0.952),respectively.The respective cut⁃off values were 272.48 ng/mL and 1.54 mg/L.The specificity for serum ferritin,Cys⁃C,and their combination was 0.652,0.560,and 0.869,respectively,while the sensitivity was 0.904,0.904,and 0.855,respectively.Conclusion Increased levels of serum ferritin and Cys⁃C are correlated with vascular calcification in MHD patients.These markers can be used

关 键 词：维持性血液透析 血管钙化 铁蛋白 胱抑素C 

分 类 号：R692.5[医药卫生—泌尿科学]