慢性肾脏病患者血清骨保护素水平及与腹主动脉钙化的相关性分析

目的：观察慢性肾脏病(CKD)3-5D期患者血清骨保护素(OPG)变化,并探讨和腹主动脉钙化(AAC)的相关性。方法选取86例CKD 3-5D期患者为研究对象,根据腹主动脉有无钙化分为AAC组和non-AAC组,应用ELISA法测定各组患者血清OPG水平；采用腹部侧位片评估AAC程度。结果86例 CKD患者中 AAC 51例(59．3%)。51例 ACC患者OPG明显高于35例non-AAC患者( P<0．01)。 CKD5期未行肾脏替代治疗患者血清OPG显著高于CKD3-4期患者(P<0．05)；CKD5D期血清OPG水平和CKD5期未行肾脏替代治疗患者OPG差异无统计学意义。血清OPG与eG-FR呈显著负相关(r=-0．357, P=0．011),与AAC程度相关(r=0．258, P=0．017)。 Logistic回归分析发现：男性(β=2．568,P=0．048)、吸烟(β=4．337,P=0．013)、OPG (β=1．273,P =0．003)是影响 AAC 的主要因素。结论在CKD患者中,血管钙化发生率高,随着肾功能恶化,血清OPG水平有升高趋势。男性、吸烟及OPG是AAC的危险因素,可能参与AAC的发生与发展。

Relationship between serum osteoprotegerin and abdominal aortic calcification

Objective To determine serum osteoprotegerin ( OPG) level in chronic kidney disease( CKD) and its relationship with abdominal aortic calcification (AAC). Methods Eighty-six patients with CKD 3-5D were recrui-ted in the study. The level of serum OPG was measured by enzyme-linked immunlsorbent assay. AAC score was as-sessed by abdominal lateral X-ray examination. Results According to the presence of AAC, the patients with CKD3-5D were divided into two groups, AAC group (n=51) and non-AAC group (n=35). Serum OPG in group AAC was relatively higher than that in non-AAC group ( P =0. 004 ) , serum OPG ( 13. 41 ± 2. 46 ) ng/ml versus OPG(11. 04 ± 2. 75) ng/ml. The level of serum OPG in CKD5 patients was higher than in CKD3-4 patients (P<0. 05), serum OPG (11. 75 ± 2. 85) ng/ml versus OPG (10. 39 ± 2. 78) ng/ml. But there was no difference be-tween predialysis CKD5 and CKD5D patients. The level of serum OPG was significantly associated with eGFR(r=-0. 357,P=0. 011),AAC degree(r=0. 258, P=0. 017). Logistic analysis showed that male (β=2. 568, P=0. 048), smoking habits(β=4. 337, P=0. 013)and OPG (β=1. 273, P=0. 003) were associated with moderate to severe AAC. Conclusion The level of serum OPG is higher in patients with CKD5 than that of CKD3-4. The results suggest that higher OPG maybe play an important role in AAC progression.