外周血环肽A水平与终末期肾病患者血管钙化及预后的关系  

Peripheral blood CyPA level and its correlation with vascular calcification and prognosis in patients with end-stage kidney disease

作　　者：马强 宋洞琪 王甲正 MA Qiang;SONG Dong-qi;WANG Jia-zheng(Department of Nephrology,Daxing District People's Hospital,Beijing 102600,China)

机构地区：[1]大兴区人民医院肾内科,北京102600

出　　处：《中国血液净化》2025年第4期288-291,295,共5页Chinese Journal of Blood Purification

摘　　要：目的研究外周血环肽A(cyclophilin A,CyPA)水平与终末期肾病(end-stage renal disease,ESRD)患者血管钙化及预后的关系。方法选取2020年4月-2024年5月收治的240例ESRD患者作为研究对象,其中血管钙化组患者156例,非钙化组患者84例。比较血管钙化组以及非血管钙化组、生存组以及死亡组患者的CyPA、血清钙(Ca^(2+))、血清磷(P^(3-))、钙磷乘积、C反应蛋白(CRP)、血清肌酐(Scr)、甲状旁腺激素(PTH)及血脂水平之间的差异,研究上述指标与死亡、血管钙化的相关性。结果钙化组及非钙化组患者的P^(3-)(t=4.140,P<0.001)、Ca^(2+)×P^(3-)(t=34.168,P<0.001)、CRP(t=40.459,P<0.001)、CyPA(t=14.743,P<0.001)、PTH(t=15.737,P<0.001)、白蛋白(t=33.470,P<0.001)之间差异有统计学意义,生存组以及死亡组患者的P^(3-)(t=15.916,P<0.001)、Ca^(2+)×P^(3-)(t=25.969,P<0.001)、CRP(t=26.705,P<0.001)、CyPA(t=9.757,P<0.001)、PTH(t=206.716,P<0.001)、白蛋白(t=57.496,P<0.001)之间存在统计学差异。多因素分析显示P^(3-)(OR=0.313,95%CI:0.233~0.420,P<0.001)、Ca^(2+)×P^(3-)(OR=0.320,95%CI:0.259~0.396,P<0.001)、CRP(OR=0.299,95%CI:0.232~0.389,P<0.001)、CyPA(OR=0.362,95%CI:0.290~0.452,P<0.001)、PTH(OR=0.343,95%CI:0.269~0.436,P<0.001)、白蛋白(OR=3.271,95%CI:2.326~4.600,P<0.001)是血管钙化的危险因素,P^(3-)(OR=0.339,95%CI:0.261~0.443,P<0.001)、Ca^(2+)×P^(3-)(OR=0.351,95%CI:0.244~0.507,P<0.001)、CRP(OR=0.345,95%CI:0.249~0.478,P<0.001)、CyPA(OR=0.303,95%CI:0.223~0.412,P<0.001)、PTH(OR=0.336,95%CI:0.274~0.412,P<0.001)、白蛋白(OR=2.965,95%CI:2.258~3.894,P<0.001)是死亡的危险因素。结论外周血CyPA水平与ESRD患者血管钙化及预后呈现显著的相关性,可作为临床诊断以及预后判定的重要依据。Objective To investigate the relationship between peripheral blood cyclophilin A(CyPA)level and vascular calcification and prognosis in patients with end-stage kidney disease(ESKD).Methods A total of 240 patients with ESKD admitted to the hospital from April 2020 to May 2024 were selected as the research objects,including 156 patients in the vascular calcification group and 84 patients in the non-calcification group.Blood CyPA level,serum calcium(Ca^(2+)),serum phosphorus(P^(3-)),Ca^(2+)x P^(3-)product,C-reactive protein(CRP),serum creatinine(Scr)and blood lipid were compared between vascular calcification group and non-calcification group and between survival group and death group to correlate these indexes with vascular calcification and death.Results P^(3-)(t=4.140,P<0.001),Ca^(2+)×P^(3-)product(t=34.168,P<0.001),CRP(t=40.459,P<0.001),CyPA(t=14.743,P<0.001),PTH(t=15.737,P<0.001)and albumin(t=33.470,P<0.001)were statistically different between vascular calcification group and non-calcification group.P^(3-)(t=15.916,P<0.001),Ca^(2+)×P^(3-)product(t=25.969,P<0.001),CRP(t=26.705,P<0.001),CyPA(t=9.757,P<0.001),PTH(t=206.716,P<0.001)and albumin(t=57.496,P<0.001)were statistically different between survival group and death group.Multivariate analysis showed that P^(3-)(OR=0.313),Ca^(2+)×P^(3-)(OR=0.320),CRP(OR=0.299),CyPA(OR=0.362),PTH(OR=0.343)and albumin(OR=3.271)were the risk factors for vascular calcification,while P^(3-)(OR=0.339),Ca^(2+)×P^(3-)product(OR=0.351),CRP(OR=0.345),CyPA(OR=0.303),PTH(OR=0.336)and albumin(OR=2.965)were the risk factors for death.Conclusion Peripheral blood CyPA level is significantly correlated with vascular calcification and survival in ESKD patients.Therefore,blood CyPA level can serve as an important indicator for the assessment of clinical diagnosis and prognosis.

关 键 词：外周血环肽A 终末期肾病 预后 相关性 

分 类 号：R692.5[医药卫生—泌尿科学]