持续不卧床腹膜透析患者血液中CatK与PTH相关性研究  

Correlation Between CatK and PTH in Continuous Ambulate Peritoneal Dialysis Patients

作　　者：莫祖荣 黄雯静[1] 谭鹤长[1] MO Zurong;HUANG Wenjing;TAN Hezhang(Department of Nephrology,the Fourth Affiliated Hospital of Guangxi Medical University,Liuzhou 545005,Guangxi.China)

机构地区：[1]广西医科大学第四附属医院肾内科,广西柳州545005

出　　处：《医学信息》2025年第6期106-112,共7页Journal of Medical Information

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(编号:Z20211254)。

摘　　要：目的探讨持续不卧床腹膜透析(CAPD)患者血液中组织蛋白酶K(CatK)与甲状旁腺激素(PTH)的相关性,寻找预测此类人群慢性肾脏病-矿物质骨代谢异常的新生物标志物。方法采用单中心横断面研究,选取2020年11月-2022年1月广西医科大学第四附属医院肾内科血液净化中心透析时间≥3个月的CAPD患者114例作为CAPD组,另选30名健康志愿者作为对照组,收集一般资料及相关指标,化学发光法检测PTH,酶联免疫吸附法测定CatK,腰椎侧位平片评估腹主动脉钙化(AAC)积分。分析CAPD组和对照组的基线数据,并根据CatK、PTH水平对CAPD患者进行分组,观察并比较各组间的基线特征差异。分析CatK、PTH与各指标的相关性,多元线性回归分析评估影响CatK、PTH的共同因素。通过ROC曲线评估CatK对PTH状态的预测价值。结果①CAPD患者的PTH、CatK水平高于对照组(P<0.05)。②CAPD患者CatK与PTH、BALP、CRP呈正相关,与活性维生素D呈负相关。与PTH达标患者相比,PTH未达标患者CatK水平更高(P<0.05)。③CatK预测PTH未达标患者的曲线下面积(AUC)为0.77(95%CI:0.67~0.86,P<0.05);当CatK取865.56 pg/ml为预测切点时,灵敏度为71.90%,特异性为70.73%。结论CAPD患者血清CatK与PTH、BALP、CRP、活性维生素D独立相关。血清CatK可作为预测CAPD患者矿物质骨代谢异常的生物标志物。Objective To investigate the correlation between blood cathepsin K(CatK)and parathyroid hormone(PTH)in patients with continuous ambulatory peritoneal dialysis(CAPD),and to find new biomarkers for predicting chronic kidney disease-mineral bone metabolic abnormalities in this population.Methods A single-center cross-sectional study was conducted.A total of 114 CAPD patients with dialysis time≥3 months in the blood purification center of the Department of Nephrology,the Fourth Affiliated Hospital of Guangxi Medical University from November 2020 to January 2022 were selected as the CAPD group,and 30 healthy volunteers were selected as the control group.General data and related indicators were collected.PTH was detected by chemiluminescence,CatK was determined by enzyme-linked immunosorbent assay,and abdominal aortic calcification(AAC)score was evaluated by lumbar lateral plain film.The baseline data of CAPD group and control group were analyzed,and CAPD patients were grouped according to CatK and PTH levels,and the baseline characteristics of patients in each group were observed and compared.The correlation between CatK,PTH and each index was analyzed,and the common factors affecting CatK and PTH were evaluated by multiple linear regression analysis.The predictive value of CatK for PTH status was evaluated by ROC curve.Results①The levels of PTH and CatK in CAPD patients were higher than those in the control group(P<0.05).②CatK was positively correlated with PTH,BALP and CRP,and negatively correlated with active vitamin D in CAPD patients.Compared with patients with PTH up to standard,patients with PTH not up to standard had higher CatK level(P<0.05).③The area under the curve(AUC)of CatK in predicting PTH failure was 0.77(95%CI:0.67-0.86,P<0.05).When CatK was 865.56 pg/ml as the predictive cut-off point,the sensitivity was 71.90%and the specificity was 70.73%.Conclusion Serum CatK is independently associated with PTH,BALP,CRP and active vitamin D in CAPD patients.Serum CatK can be used as a biomarker to predic

关 键 词：持续不卧床腹膜透析 组织蛋白酶K 甲状旁腺激素 

分 类 号：R692.5[医药卫生—泌尿科学]