摘要
目的探讨不同程度血管钙化的维持性血液透析(MHD)患者血清中Klotho蛋白水平的变化情况及分析讨论其对临床的意义。方法选取2019年2月-2020月12月于本院进行MHD治疗的患者136例,采用简易血管钙化评分,进行X线片检查将患者分为无钙化、轻度钙化、重度钙化、重度钙化等4类,同时检测不同程度血管钙化患者的血红蛋白(Hb)、血磷(P)、血钙(Ca)、血清白蛋白(ALB)、全段甲状旁腺激素(iPTH)、血清FGF-23和血清Klotho蛋白等指标,分析血清Klotho蛋白水平的变化情况及其临床意义。结果136例MHD患者中,共有103例(75.74%)患者发生了血管钙化,其中无钙化患者33例(24.26%),轻度钙化患者41例(30.15%),中度钙化患者37例(27.21%),重度钙化25例(18.38%);不同程度血管钙化患者的临床参数比较中,年龄、糖尿病史、P、Ca、iPTH、血清FGF-23及血清Klotho蛋白水平差异具有统计学意义(P<0.05);在logistic回归分析中,年龄越大、有糖尿病史、血清FGF-23水平升高及血清Klotho蛋白水平降低是血管钙化程度的独立危险因素(P<0.05);MHD患者的血管钙化程度与血清FGF-23水平呈正相关的关系(r=0.547,P<0.05),而其与Klotho蛋白水平呈负相关的关系(r=-0.372,P<0.05)。结论在MHD患者中普遍存在不同程度的血管钙化,其中血清Klotho蛋白水平与血管钙化的严重程度呈负相关,血清Klotho蛋白水平的下降是导致血管钙化的独立危险因素,检测血清Klotho蛋白水平的变化情况,对于判断血管钙化的严重程度有重要意义。
Objective To investigate the changes of serum Klotho protein levels in maintenance hemodialysis(MHD)patients with different degrees of vascular calcification and to analyze and discuss its clinical significance.Methods 136 patients who were treated for MHD in our hospital from February 2019 to December 2020 were selected.The simple vascular calcification score was used and X-ray examination was performed to divide the patients into 4 categories:no calcification,mild calcification,severe calcification,and severe calcification.Simultaneously detect hemoglobin(Hb),blood phosphorus(P),blood calcium(Ca),serum albumin(ALB),whole parathyroid hormone(iPTH),serum FGF-23 in patients with different degrees of vascular calcification and serum Klotho protein and other indicators to analyze the changes in serum Klotho protein levels and their clinical significance.Results Among 136 patients with MHD,a total of 103(75.74%)patients had vascular calcification,of which 33 patients(24.26%)had no calcification,41 patients(30.15%)had mild calcification,and 37 patients(27.21%)had moderate calcification,25 cases of severe calcification(18.38%);in the comparison of clinical parameters of patients with different degrees of vascular calcification,the differences in age,diabetes history,P,Ca,iPTH,serum FGF-23 and serum Klotho protein levels were statistically significant(P<0.05);in logistic regression analysis,the older the age,the history of diabetes,the increase of serum FGF-23 level and the decrease of serum Klotho protein level were the degree of vascular calcification Independent risk factors(P<0.05);the degree of vascular calcification in MHD patients was positively correlated with serum FGF-23 levels(r=0.547,P<0.05),and it was negatively correlated with Klotho protein levels(r=-0.372,P<0.05).Conclusion Different degrees of vascular calcification are common in MHD patients.The serum Klotho protein level is negatively correlated with the severity of vascular calcification.The decrease of serum Klotho protein level is an independent risk factor for vascular calcification.Therefore,the detection of serum Klotho protein level is of great significance in judging the severity of vascular calcification.
作者
于敬
Yu Jing(Aerospace General Hospital of Beijing,Beijing,100076,China)
出处
《新疆医学》
2022年第11期1276-1278,1297,共4页
Xinjiang Medical Journal
关键词
血管钙化
维持性血液透析
KLOTHO蛋白
临床意义
vascular calcification
maintenance hemodialysis
Klotho protein
clinical significance
作者简介
于敬,女,主管护师,研究方向:血液透析。
