维持性血液透析患者血清内脂素与冠状动脉钙化的相关性研究  

A study on the correlation between serum visfatin and coronary artery calcification in maintenance hemodialysis patients

作　　者：焦建[1] 王小琪 邵枫 袁丹[1] 李忠心[1] Jiao Jian;Wang Xiaoqi;Shao Feng;Yuan Dan;Li Zhongxin(Department of Nephrology,Beijing Luhe Hospital,Capital Medical University,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京潞河医院肾病中心,北京101149

出　　处：《首都医科大学学报》2024年第6期1095-1099,共5页Journal of Capital Medical University

基　　金：北京潞河医院临床研究项目(LHYY2023-YJZ009)。

摘　　要：目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者血清内脂素与冠状动脉钙化(coronary artery calcification,CAC)的相关性。方法应用横断面研究法,收集2023年7月1日至2024年2月29日首都医科大学附属北京潞河医院的MHD患者的临床资料,检测血清内脂素水平,应用低剂量胸部多层螺旋电子计算机断层扫描(computed tomography,CT)评估患者CAC情况并分组比较,应用多因素Logistic回归法分析CAC的独立影响因素;应用受试者工作特征(receiver operating characteristic,ROC)曲线分析影响因素对MHD患者发生CAC的预测价值。结果本研究共纳入135例MHD患者,分为无CAC组(n=39)和CAC组(n=96);2组患者的年龄、合并糖尿病、血清内脂素、血糖、血钠、尿素清除指数(urea clearance index,Kt/V)差异均有统计学意义(P<0.05);多因素Logistic回归分析发现高龄、血清内脂素升高以及合并糖尿病是MHD患者发生CAC的独立危险因素。ROC曲线显示,血清内脂素单独预测CAC的曲线下面积(area under the curve,AUC)为0.751(P<0.01),具有较高的预测价值。结论血清内脂素升高是MHD患者发生CAC的独立危险因素,可能成为预测CAC的生物学指标。Objective To investigate the correlation between serum visfatin and coronary artery calcification(CAC)in maintenance hemodialysis(MHD)patients.Methods In this cross-sectional study,the general data of MHD patients in Beijing Luhe Hospital,Capital Medical University were collected from July 1,2023 to February 29,2024.The serum visfatin level were detected.CAC level was evaluated by low-dose chest multi spiral computed tomography(CT).According to the results of CT,the patients were divided into 2 groups,clinical characteristics were compared between 2 groups,multivariate Logistic regression was used to analyze the independent influencing factors of CAC.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of influencing factors for CAC in MHD patients.Results Totally 135 MHD patients were enrolled in this study and divided into non-CAC group(n=39)and CAC group(n=96).There were significant differences in age,diabetes mellitus,visfatin,blood glucose,serum sodium and urea clearance index(Kt/V)between the two groups(P<0.05).Multivariate Logistic regression analysis showed that older age,higher serum visfatin level and diabetes were independent risk factors for CAC in MHD patients.ROC curve showed that the area under the curve(AUC)of serum visfatin for predicting CAC in MHD patients was 0.751(P<0.01),which had high predictive value.Conclusions Increased serum visfatin level is an independent risk factor for CAC,and may be a potential biomarker for predicting CAC in MHD patients.

关 键 词：维持性血液透析 血清内脂素 冠状动脉钙化 低剂量胸部多层螺旋电子计算机断层平扫 

分 类 号：R543[医药卫生—心血管疾病]