血清可溶性CD40配体、腱糖蛋白C、甲壳质酶蛋白-40联合检测对维持性血液透析并发心血管事件的预测作用  

Effect of serum sCD40L,TN-C and YKL-40 combined detectionon cardiovascular events during maintenance hemodialysis

作　　者：吕宁[1] 杨立娟[1] 尹林林 王丹[1] 宴俊芳 LV Ning;YANG Lijuan;YIN Linlin;WANG Dan;YAN Junfang(Department of Nephrology,Handan Central Hospital,Handan 056001,China)

机构地区：[1]邯郸市中心医院肾内一科,河北邯郸056001

出　　处：《陕西医学杂志》2025年第1期123-126,137,共5页Shaanxi Medical Journal

基　　金：河北省卫生健康委员会科研项目(2022SF-1036)。

摘　　要：目的:探讨血清可溶性CD40配体(sCD40L)、腱糖蛋白C(TN-C)、甲壳质酶蛋白-40(YKL-40)联合检测对维持性血液透析(MHD)并发心血管事件的预测价值。方法:选择170例MHD患者为研究对象,依据不良心血管事件(MACE)发生情况分两组,即MACE组(n=63)和非MACE组(n=107),另选同期健康体检者为对照组(n=152)。比较各组血清sCD40L、TN-C、YKL-40水平,分析以上指标与MHD发生MACE的相关性及MHD并发MACE的危险因素,绘制受试者工作曲线(ROC)分析其预测价值。结果:MHD组血清sCD40L、TN-C、YKL-40水平高于对照组(均P<0.05)。MACE组的年龄、透析龄及血清sCD40L、TN-C、YKL-40水平高于非MACE组(均P<0.05)。MHD并发MACE与年龄、透析龄及血清sCD40L、TN-C、YKL-40水平呈正相关(均P<0.05)。多因素Logistic回归分析显示,MHD并发MACE的独立危险因素包括高水平sCD40L、TN-C、YKL-40以及高年龄和透析龄(均P<0.05)。血清sCD40L、TN-C、YKL-40单独及联合预测MHD并发MACE的AUC分别为0.701、0.679、0.754、0.875,联合预测价值最高,其次为YKL-40、sCD40L、TN-C(均P<0.05)。结论:MHD并发MACE患者血清sCD40L、TN-C、YKL-40水平有升高趋势,三者均为MACE发生独立危险因素,联合检测对MHD发生MACE有一定的预测价值。Objective:To investigate the predictive value of serum sCD40L,TN-C and YKL-40 combined detection on cardiovascular events during maintenance hemodialysis.Methods:A total of 170 MHD patients were selected and divided into two groups according to the occurrence of adverse cardiovascular events(MACE),namely,MACE group(n=63)and non-MACE group(n=107),and healthy subjects in the same period were selected as control group(n=152).Serum levels of sCD40L,TN-C and YKL-40 in all groups were compared,the correlation between the above indexes and MACE in MHD and the risk factors of MHD complicated MACE were analyzed,and the predictive value was analyzed by receiver operating curve(ROC).Results:Serum levels of sCD40L,TN-C and YKL-40 in MHD group were higher than those in control group(all P<0.05).The age,dialysis age and serum levels of sCD40L,TN-C and YKL-40 in MACE group were higher than those in non-MACE group(all P<0.05).The incidence of MACE in MHD patients was positively correlated with age,dialysis age and serum levels of sCD40L,TN-C and YKL-40(all P<0.05).Multivariate Logistic regression analysis showed that the independent risk factors for MACE in MHD patients included high levels of sCD40L,TN-C,YKL-40,and high age and dialysis age(all P<0.05).The AUC of serum sCD40L,TN-C and YKL-40 alone and combined to predict MHD with MACE were 0.701,0.679,0.754 and 0.875,respectively,and the combined prediction value was the highest,followed by YKL-40,sCD40L and TN-C(all P<0.05).Conclusion:The serum levels of sCD40L,TN-C and YKL-40 in MHD patients complicated with MACE tend to increase,and the three are independent risk factors for MACE development.Combined detection has certain predictive value for MACE development in MHD.

关 键 词：维持性血液透析 心血管事件 可溶性CD40配体 腱糖蛋白C 甲壳质酶蛋白-40 预测 

分 类 号：R541[医药卫生—心血管疾病]