MCP-1、vWF-cp及GK1与维持性血液透析患者血管钙化的关系  

The relationship between monocyte chemoattractant protein factor-1,von Willebrand factor-cleaving protease and glucocorticoid-regulated protein kinase 1 and vascular calcification in MHD patients

作　　者：杨薇 康宇薇 马石杰 周薇 袁巾堰 贺欣 李华斌 邓菲 YANG Wei;KANG Yuwei;MA Shijie;ZHOU Wei;YUAN Jinyan;HE Xin;LI Huabin;DENG Fei(Department of Nephrology,The Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan,China;Department of Nephrology,School of Medicine,University of Electronic Science and Technology,Sichuan Academy of Medical Sciences,Sichuan Provincial People's Hospital,Chengdu 610072,China;Chengdu Kangfu Kidney Disease Hospital,Chengdu 610047,China;Sichuan Desen Kidney Disease Hospital,Chengdu 610047,China;Department of Nephrology,Jinniu District People's Hospital,Chengdu 610036,China)

机构地区：[1]西南医科大学附属医院肾病内科,四川泸州646000 [2]电子科技大学医学院·四川省医学科学院·四川省人民医院肾脏内科,四川成都610072 [3]成都康福肾脏病医院,四川成都610047 [4]四川德森肾脏病医院,四川成都610047 [5]成都市金牛区人民医院肾脏内科,四川成都610036

出　　处：《西部医学》2025年第2期247-251,共5页Medical Journal of West China

基　　金：四川省干部保健科研项目(川干研2021-231);四川省医学科研课题(S20014&S21002);成都市医学科研课题(2020208);金牛区医学会2021年科研课题(JNKY2021-85)。

摘　　要：目的 探讨单核细胞趋化蛋白因子-1(MCP-1)、血管性血友病因子裂解酶(vWF-cp)及糖皮质激素调节蛋白激酶1(GK1)与维持性血液透析(MHD)患者血管钙化的关系。方法 回顾性分析2019年1月—2021年1月四川省人民医院、金牛区人民医院、成都康福肾脏病医院、四川德森肾脏病医院收治的127例MHD患者的临床资料,将其设为观察组,根据有无出现血管钙化又将观察组分为钙化组(n=51)、未钙化组(n=76)。同时选取86例同时期体检健康者作为对照组。比较MCP-1、vWF-cp、GK1水平,分析影响MHD患者血管钙化的因素。结果 观察组MCP-1、GK1水平高于对照组,而vWF-cp水平低于对照组(P<0.05)。钙化组MCP-1、GK1水平高于未钙化组,而vWF-cp水平低于未钙化组(均P<0.05)。性别、高血压、糖尿病等非影响MHD患者血管钙化的单因素(P>0.05),年龄、透析龄、血钙、钙磷乘积、吸烟史、MCP-1、vWF-cp、GK1为影响MHD患者血管钙化的单因素(P<0.05)。经非条件多因素logistic回归模型分析显示,年龄、透析龄、血钙、钙磷乘积、MCP-1、vWF-cp、GK1为影响MHD患者血管钙化的独立危险因素(P<0.05)。结论 MHD患者通常伴随有MCP-1、GK1水平升高,vWF-cp水平降低,且MCP-1、vWF-cp、GK1是其血管钙化的影响因素,临床可根据其水平变化进行针对性干预,预防血管钙化的发生。Objective To study the relationship between monocyte chemoattractant protein factor-1(MCP-1),von Willebrand factor-cleaving protease(vWF-cp) and glucocorticoids glucocorticoid-regulated protein kinase 1(GK1) and vascular calcification in maintenance hemodialysis(MHD) patients.Methods The clinical data of 127 MHD patients admitted to 4 hospitals from January 2019 to January 2021 were retrospectively analyzed,and they were set as the study group,and according to the presence or absence of vascular calcification,they were divided into the calcification group(n= 51),non-calcified group(n=76).At the same time,86 healthy subjects with physical examination during the same period were selected as the control group.The levels of MCP-1,vWF-cp and GK1 were compared,and the factors affecting vascular calcification in MHD patients were analyzed.Results The levels of MCP-1 and GK1 in the study group were higher than those in the control group,while the level of vWF-cp was lower than that in the control group(P<0.05).The levels of MCP-1 and GK1 in the calcified group were higher than those in the non-calcified group,while the level of vWF-cp was lower than that in the non-calcified group(P<0.05).Gender,hypertension,diabetes and other factors were not the single factors affecting vascular calcification in MHD patients(P>0.05),while age,dialysis age,serum calcium,calcium-phosphorus product,smoking history,MCP-1,vWF-cp,and GK1 were the single factors affecting vascular calcification in MHD patients(P<0.05).Unconditional multivariate logistic regression model analysis showed that age,dialysis age,serum calcium,calcium-phosphorus product,MCP-1,vWF-cp,GK1 were independent risk factors for vascular calcification in MHD patients(P<0.05).Conclusion MHD patients are usually accompanied by increased levels of MCP-1 and GK1,and decreased levels of vWF-cp,and MCP-1,vWF-cp,and GK1 are the influencing factors of vascular calcification,and clinically,targeted intervention can be carried out according to its level changes to prevent the occurre

关 键 词：单核细胞趋化蛋白因子-1 血管性血友病因子裂解酶 糖皮质激素调节蛋白激酶1 维持性血液透析患者 血管钙化 

分 类 号：R692.5[医药卫生—泌尿科学]