中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2008年
7期
456-460
,共5页
韦洮%王梅%甘良英%王宓%李欣%赵青艺%檀敏
韋洮%王梅%甘良英%王宓%李訢%趙青藝%檀敏
위조%왕매%감량영%왕복%리흔%조청예%단민
肾透析%血管%钙质沉着症%骨密度%骨保护素%骨保护素配体
腎透析%血管%鈣質沉著癥%骨密度%骨保護素%骨保護素配體
신투석%혈관%개질침착증%골밀도%골보호소%골보호소배체
Renal dialysis%Blood vessels%Calcinosis%Bone density%Osteoprotegerin%Soluble receptor activator of NF-kB ligand
目的 研究维持性血液透析(MHD)患者血管钙化、骨密度与血清骨保护素(OPG)及其配体sRANKL的相互关系.方法 采用酶联免疫吸附法测定血清OPG、sRANKL水平;X线平片检测腹主动脉、股动脉及桡动脉部位血管钙化,计算血管钙化积分;双能X线骨密度仪测定腰椎及股骨骨密度.对各参数的相互关系进行统计分析.结果 (1)39例MHD患者中25例(64.1%)在不同部位有不同程度的血管钙化,其中轻度钙化16例(41.0%),中重度钙化9例(23.1%).中重度钙化者血清OPG水平、OPG/sRANKL比值显著高于轻度钙化者[(342.50±171.53)ng/L比(206.21±137.88)ng/L,t=-2.253,P=0.025;454.65±455.63比135.31±136.81,t=59,P=0.035],而sRANKL水平差异无统计学意义[(0.10±0.08)pmol/L比(0.12±0.08)pmol/L,t=0.534,P>0.05].多元线性回归分析显示OPG/sRANKL是血管钙化评分的独立影响因素.(2)与骨量正常者比较,骨量异常者血清OPG水平升高[(249.05±137.66)ng/L比(226.674-170.12)ng/L],sRANKL水平降低[(0.11±0.08)pmol/L比(0.12±0.02)pmol/L],OPG/sRANKL比值升高(202.31±219.24比148.08±210.10),但差异均无统计学意义.多元线性回归分析显示OPG/sRANKL是腰椎T值的独立影响因素.(3)多元线性回归分析显示血管钙化评分是腰椎和股骨T值的独立影响因素.结论 MHD患者血管钙化程度是腰椎及股骨骨密度的独立影响因素,OPG/sRANKL可能在血管钙化和骨密度的关系中起了纽带作用.
目的 研究維持性血液透析(MHD)患者血管鈣化、骨密度與血清骨保護素(OPG)及其配體sRANKL的相互關繫.方法 採用酶聯免疫吸附法測定血清OPG、sRANKL水平;X線平片檢測腹主動脈、股動脈及橈動脈部位血管鈣化,計算血管鈣化積分;雙能X線骨密度儀測定腰椎及股骨骨密度.對各參數的相互關繫進行統計分析.結果 (1)39例MHD患者中25例(64.1%)在不同部位有不同程度的血管鈣化,其中輕度鈣化16例(41.0%),中重度鈣化9例(23.1%).中重度鈣化者血清OPG水平、OPG/sRANKL比值顯著高于輕度鈣化者[(342.50±171.53)ng/L比(206.21±137.88)ng/L,t=-2.253,P=0.025;454.65±455.63比135.31±136.81,t=59,P=0.035],而sRANKL水平差異無統計學意義[(0.10±0.08)pmol/L比(0.12±0.08)pmol/L,t=0.534,P>0.05].多元線性迴歸分析顯示OPG/sRANKL是血管鈣化評分的獨立影響因素.(2)與骨量正常者比較,骨量異常者血清OPG水平升高[(249.05±137.66)ng/L比(226.674-170.12)ng/L],sRANKL水平降低[(0.11±0.08)pmol/L比(0.12±0.02)pmol/L],OPG/sRANKL比值升高(202.31±219.24比148.08±210.10),但差異均無統計學意義.多元線性迴歸分析顯示OPG/sRANKL是腰椎T值的獨立影響因素.(3)多元線性迴歸分析顯示血管鈣化評分是腰椎和股骨T值的獨立影響因素.結論 MHD患者血管鈣化程度是腰椎及股骨骨密度的獨立影響因素,OPG/sRANKL可能在血管鈣化和骨密度的關繫中起瞭紐帶作用.
목적 연구유지성혈액투석(MHD)환자혈관개화、골밀도여혈청골보호소(OPG)급기배체sRANKL적상호관계.방법 채용매련면역흡부법측정혈청OPG、sRANKL수평;X선평편검측복주동맥、고동맥급뇨동맥부위혈관개화,계산혈관개화적분;쌍능X선골밀도의측정요추급고골골밀도.대각삼수적상호관계진행통계분석.결과 (1)39례MHD환자중25례(64.1%)재불동부위유불동정도적혈관개화,기중경도개화16례(41.0%),중중도개화9례(23.1%).중중도개화자혈청OPG수평、OPG/sRANKL비치현저고우경도개화자[(342.50±171.53)ng/L비(206.21±137.88)ng/L,t=-2.253,P=0.025;454.65±455.63비135.31±136.81,t=59,P=0.035],이sRANKL수평차이무통계학의의[(0.10±0.08)pmol/L비(0.12±0.08)pmol/L,t=0.534,P>0.05].다원선성회귀분석현시OPG/sRANKL시혈관개화평분적독립영향인소.(2)여골량정상자비교,골량이상자혈청OPG수평승고[(249.05±137.66)ng/L비(226.674-170.12)ng/L],sRANKL수평강저[(0.11±0.08)pmol/L비(0.12±0.02)pmol/L],OPG/sRANKL비치승고(202.31±219.24비148.08±210.10),단차이균무통계학의의.다원선성회귀분석현시OPG/sRANKL시요추T치적독립영향인소.(3)다원선성회귀분석현시혈관개화평분시요추화고골T치적독립영향인소.결론 MHD환자혈관개화정도시요추급고골골밀도적독립영향인소,OPG/sRANKL가능재혈관개화화골밀도적관계중기료뉴대작용.
Objective To examine the interrelations among vascular calcification, bone denaity,osteoprotegerin (OPG) and soluble receptor activator of NF-kB ligand (sRANKL) in maintenance hemodialysis (MHD) patients. Methods The levels of serum OPG and sRANKL from 39 MHD patients were measured by ELISA. The vascular calcification was detected by plain radiographs. Bone mineral density (BMD) was measured with dual-energy X-ray absorptionmeter.Interrelations among above parameters were examined statistically. Results (1) Among 39 MHD patients, 25 cases were identified as vascular calcification by radiographic film. The proportion of patients with mild vascular calcification was 41.0% (16 cases), moderate and severe vascular calcification was 23.1% (9 cases). Compared to patients with mild vascular calcification,serum OPG level [(342.50±171.53) ng/L vs (206.21±137.88) ng/L,t=-2.253, P=0.0251 and OPG/sRANKL ratio (454.65±455.63 vs 135.31±136.81, t=59, P=0.035)were significantly higher in patients with moderate and severe vascular calcification,while serum sRANKL level [(0.10±0.08) pmol/L vs (0.12±0.08) pmol/L, t=0.534, P>0.05] was not significantly different. Multiple linear regression analysis showed that OPG/sRANKL ratio was independent factor of vascular calcification score. (2)Compared to patients with normal bone volume, the patients with abnormal bone volume had higher serum OPG level [(249.05±137.66) ng/L vs (226.67±170.12) ng/L], lowerserum sRANKL level [(0.11±0.08) pmol/L vs (0.12±0.02) pmol/L], and higher OPG/sRANKL ratio(202.31±219.24 vs 148.08±210.10), but these parameters were not significantly different betweenthese two groups. Multiple linear regression analysis showed that OPG/sRANKL ratio was anindependent factor of T score of lumbar vertebra. (3)Muhiple linear regression analysis revealed that vascular calcification score was an independent factor of T score of lumbar vertebra and hip.Conclusions Vascular calcification score is an independent factor of BMD of lumbar vertebra and hip in MHD patients. Serum OPG/sRANKL ratio may play an important role in the association between vascular calcification and BMD in MHD patients.
