慢性肾脏病患者血清总钙蛋白颗粒、骨桥蛋白、同型半胱氨酸水平及与血管钙化的相关性研究  

Serum Levels of Total Calciprotein Particles,Osteopontin,Homocysteine and Their Correlation with Vascular Calcification in Patients with Chronic Kidney Disease

作　　者：董丽明[1] 李本皓 李莉[1] 米克热衣·艾孜买提[2] 李寅辉[4] DONG Liming;LI Benhao;LI Lia;Mikereyi Aizimaiti;LI Yinhui(State Key Laboratory of Pathogenesis,Prevention and Treatment of High-Incidence Diseases in Central Asia,Department of Clinical Nutrition,Urumqi 830000,China;State Key Laboratory of Pathogenesis,Prevention and Treatment of High-Incidence Diseases in Central Asia,the First Department of Nephrology,Kidney Disease Center,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China;Department of Rehabilitation,the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University,Urumqi 830000,China;Department of Endocrinology,the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]省部共建中亚高发病成因与防治国家重点实验室,新疆医科大学第一附属医院临床营养科,乌鲁木齐830000 [2]省部共建中亚高发病成因与防治国家重点实验室,新疆医科大学第一附属医院肾脏疾病中心肾病一科,乌鲁木齐830000 [3]新疆医科大学附属中医医院康复科,乌鲁木齐830000 [4]新疆医科大学附属中医医院内分泌科,乌鲁木齐830000

出　　处：《临床误诊误治》2025年第4期60-65,共6页Clinical Misdiagnosis & Mistherapy

基　　金：省部共建中亚高发病成因与防治国家重点实验室开放课题资助项目(SKL-HIDCA-2021-35)。

摘　　要：目的分析慢性肾脏病(CKD)患者血清总钙蛋白颗粒(TCPP)、骨桥蛋白(OPN)、同型半胱氨酸(Hcy)水平及与血管钙化的相关性、预测发生效能。方法选取2022年8月至2023年8月收治的CKD患者120例为研究对象,按照是否发生血管钙化分为钙化组(n=40)及未钙化组(n=80)。比较2组基线资料及血清生化指标(钙、磷、TCPP、OPN及Hcy)水平,分析血清TCPP、OPN及Hcy与CKD患者血管钙化的相关性。结果2组性别、合并高血压、合并糖尿病、吸烟史、饮酒史、体质量指数、原发性疾病等基线资料比较差异无统计学意义(P>0.05);钙化组血清钙、磷、TCPP、OPN、Hcy水平以及年龄≥65岁占比均高于未钙化组(P<0.01)。logistic回归分析显示,年龄、钙、磷、TCPP、OPN及Hcy均是CKD患者血管钙化的独立危险因素(P<0.01)。受试者工作特征曲线分析显示,血清TCPP、OPN、Hcy及三者联合预测CKD患者血管钙化的曲线下面积分别为0.801、0.824、0.803及0.932,具有一定预测价值。联合预测的曲线下面积明显大于TCPP、OPN、Hcy单独预测(P<0.01)。CKD血管钙化患者血清TCPP、OPN及Hcy与钙、磷呈显著正相关(P<0.01)。结论血清TCPP、OPN及Hcy水平在CKD血管钙化患者中异常升高,与血管钙化的发生密切相关。Objective To analyze the serum levels of total calciprotein particles(TCPP),osteopontin(OPN)and homocysteine(Hcy)in patients with chronic kidney disease(CKD),their correlation with vascular calcification and their predictive efficacy.Methods A total of 120 patients with CKD admitted from August 2022 to August 2023 were selected as the research subjects,and were divided into the calcification group(n=40)and the non-calcification group(n=80)according to occurrence of vascular calcification.The baseline data and levels of serum biochemical indexes calcium,phosphorus,TCPP,OPN and Hcy of the two groups were compared,and the correlation between serum TCPP,OPN and Hcy and vascular calcification in patients with CKD was analyzed.Results There was no significant difference in gender,combined hypertension,combined diabetes,smoking history,drinking history,body mass index,primary disease and other baseline data between the two groups(P>0.05).The levels of serum calcium,phosphorus,TCPP,OPN,Hcy and the proportion of patients aged≥65 years in calcification group were higher than those in non-calcification group(P<0.01).Logistic regression analysis showed that age,calcium,phosphorus,TCPP,OPN and Hcy were independent risk factors for vascular calcification in patients with CKD(P<0.01).The analysis of receiver operating characteristic(ROC)curve showed that the area under the ROC curve(AUC)of serum TCPP,OPN,and Hcy,alone and in combination,for the prediction of vascular calcification in patients with CKD was 0.801,0.824,0.803 and 0.932,respectively,showing certain predictive value.The AUC of the above indicators in combination for the diagnosis was significantly greater than that predicted by TCPP,OPN and Hcy alone(P<0.01).Serum TCPP,OPN and Hcy were significantly and positively correlated with calcium and phosphorus in CKD patients with vascular calcification(P<0.01).Conclusion Serum levels of TCPP,OPN and Hcy are abnormally elevated in CKD patients with vascular calcification,which is closely related to the occurrence of vascu

关 键 词：慢性肾脏病 血管钙化 钙蛋白颗粒 骨桥蛋白 同型半胱氨酸 危险因素 预测价值 相关性 

分 类 号：R692[医药卫生—泌尿科学]