终末期肾病血液透析患者血清endocan、8-OHdG与不宁腿综合征的关系  

Relationship between serum endocan,8-OHdG and restless leg syndrome in patients with end-stage renal disease on hemodialysis

作　　者：韩帅 邵兵 杨微 张艳宁 Han Shuai;Shao Bing;Yang Wei;Zhang Yanning(Graduate School of Jinzhou Medical University,Jinzhou 121001,China;Department of Nephrology,Shenyang First People′s Hospital,Shenyang 110041,China;Department of Nephrology,Liaoning Electric Power Center Hospital,Shenyang 110403,China;Department of Nephrology,Northern Theater Command General Hospital of the Chinese People′s Liberation Army,Shenyang 110015,China)

机构地区：[1]锦州医科大学研究生学院,锦州121001 [2]沈阳市第一人民医院肾内科,沈阳110041 [3]辽宁电力中心医院肾内科,沈阳110403 [4]中国人民解放军北部战区总医院肾内科,沈阳110015

出　　处：《中国医师杂志》2025年第2期195-200,共6页Journal of Chinese Physician

基　　金：辽宁省自然科学基金(2022-455)。

摘　　要：目的探讨终末期肾病(ESRD)血液透析患者血清内皮细胞特异性分子(endocan)、8-羟基-2′-脱氧鸟苷(8-OHdG)与不宁腿综合征(RLS)的关系。方法前瞻性选取2021年5月-2023年5月沈阳市第一人民医院、辽宁电力中心医院、中国人民解放军北部战区总医院三家医院收治的180例ESRD血液透析患者,根据是否发生RLS分为RLS组(41例)和非RLS组(139例)。根据国际RLS评定量表(IRLS)将RLS患者分为轻度组(12例)、中度组(19例)、重度组(10例)。采用酶联免疫吸附法检测患者血清endocan、8-OHdG水平。采用Pearson相关性分析法评估RLS患者血清endocan、8-OHdG水平与IRLS评分的相关性,多因素logistic回归模型分析ESRD血液透析患者发生RLS的影响因素,受试者工作特征(ROC)曲线分析血清endocan、8-OHdG水平对ESRD血液透析患者RLS的诊断价值。结果与非RLS组[(4.03±1.23)ng/ml、(0.38±0.13)ng/ml]比较,RLS组血清endocan[(6.10±1.95)ng/ml]、8-OHdG[(0.53±0.14)ng/ml]水平较高(t=8.180、6.379,均P<0.001)。轻度组、中度组、重度组RLS患者血清endocan[(3.61±1.01)ng/ml、(6.39±1.41)ng/ml、(8.54±2.68)ng/ml]、8-OHdG[(0.39±0.07)ng/ml、(0.51±0.05)ng/ml、(0.74±0.08)ng/ml]水平依次升高(F=23.065、83.013,均P<0.001)。Pearson相关性分析显示,RLS患者血清endocan、8-OHdG水平与IRLS评分呈正相关(r=0.813、0.830,均P<0.001)。多因素logistic回归分析显示,透析时间偏长、血清endocan升高、8-OHdG升高为ESRD血液透析患者发生RLS的独立危险因素,铁蛋白升高为独立保护因素(均P<0.05)。ROC曲线分析显示,血清endocan、8-OHdG水平联合诊断ESRD血液透析患者RLS的曲线下面积为0.919(95%CI:0.870~0.955),大于血清endocan、8-OHdG水平单独诊断的0.791(95%CI:0.724~0.848)、0.780(95%CI:0.712~0.838)。结论血清endocan、8-OHdG升高与ESRD血液透析患者RLS发生及病情程度加重有关,血清endocan、8-OHdG水平联合检测对ESRD血液透析患者发生RLS的诊断价值较高ObjectiveTo investigate the relationship between serum endothelia cell-specific molecules(endocan),8-hydroxy-2′deoxyguanosine(8-OHdG)and restless legs syndrome(RLS)in patients with end-stage renal disease(ESRD)on hemodialysis.MethodsA total of 180 ESRD hemodialysis patients admitted to the Shenyang First People′s Hospital,the Liaoning Electric Power Center Hospital and the Northern Theater Command General Hospital of the Chinese People′s Liberation Army from May 2021 to May 2023 were prospectively selected and divided into RLS group(41 cases)and non-RLS group(139 cases)according to whether RLS occurred.According to the International RLS Rating Scale(IRLS),the patients with RLS were divided into mild group(12 cases),moderate group(19 cases)and severe group(10 cases).Serum endocan and 8-OHdG levels were detected by enzyme-linked immunosorbent assay.Pearson correlation was used to analyze the correlation between serum endocan,8-OHdG levels and IRLS scores in RLS patients.Multivariate logistic regression model was used to evaluate the influencing factors of RLS in ESRD hemodialysis patients.The diagnostic value of serum endocan and 8-OHdG levels in ESRD hemodialysis patients was analyzed by receiver operating characteristic(ROC)curve.ResultsComparing with the non-RLS group[(4.03±1.23)ng/ml,(0.38±0.13)ng/ml],the levels of serum endocan in the RLS group[(6.10±1.95)ng/ml],8-OHdG[(0.53±0.14)ng/ml]were higher(t=8.180,6.379,P<0.001).The levels of serum endocan of the RLS patients in the mild,moderate and severe groups[(3.61±1.01)ng/ml,(6.39±1.41)ng/ml,(8.54±2.68)ng/ml],8-OHdG[(0.39±0.07)ng/ml,(0.51±0.05)ng/ml,(0.74±0.08)ng/ml]were increased successively(F=23.065,83.013,P<0.001).Pearson correlation analysis showed that serum endocan and 8-OHdG levels were positively correlated with IRLS scores in RLS patients(r=0.813,0.830,P<0.001).Multivariate logistic regression analysis showed that long dialysis time,elevated serum endocan and 8-OHdG were independent risk factors for RLS in ESRD hemodialysis patients,and

关 键 词：血液透析 终末期肾病 内皮细胞特异性分子 8-羟基-2′-脱氧鸟苷 不宁腿综合征 

分 类 号：R69[医药卫生—泌尿科学]