南方医科大学学报
南方醫科大學學報
남방의과대학학보
JOURNAL OF SOUTHERN MEDICAL UNIVERSITY
2013年
11期
1689-1691
,共3页
慢性肾脏疾病%胎球蛋白A%颈动脉%钙化%肾小球滤过率
慢性腎髒疾病%胎毬蛋白A%頸動脈%鈣化%腎小毬濾過率
만성신장질병%태구단백A%경동맥%개화%신소구려과솔
chronic kidney disease%fetuin-A%carotid artery%calcification%glomerular filtration rate
目的：研究血清胎球蛋白A（fetuin-A）与慢性肾脏病患者（CKD）残存肾功能的关系及其对颈动脉钙化的影响。方法采集CKD3期、4期、5期各20例患者的血液样本，检测血清肌酐、钙、磷、白蛋白、脂蛋白及胆固醇水平，应用MDRD公式采用血清肌酐计算肾小球滤过率（eGFR），采用免疫酶联吸附法（ELISA）测定Fetuin-A值，颈动脉彩色超声检测颈动脉钙化。结果随着eGFR的下降，Fetuin-A水平在CKD4期患者明显低于CKD3期（P<0.05），CKD5期明显低于CKD4期（P<0.05），Fetuin-A与eGFR呈线性正相关；颈动脉钙化的发生率随eGFR下降逐渐增加，CKD5期颈动脉钙化发生率最高，等级相关分析显示Fetuin-A与颈动脉钙化的发生呈负相关，Logistic回归分析显示血浆Fetuin-A水平降低是ESRD患者颈动脉钙化的危险因素。结论Fetuin-A血浆浓度随肾功能下降逐渐下降，是CKD患者颈动脉钙化发生的危险因素之一。
目的：研究血清胎毬蛋白A（fetuin-A）與慢性腎髒病患者（CKD）殘存腎功能的關繫及其對頸動脈鈣化的影響。方法採集CKD3期、4期、5期各20例患者的血液樣本，檢測血清肌酐、鈣、燐、白蛋白、脂蛋白及膽固醇水平，應用MDRD公式採用血清肌酐計算腎小毬濾過率（eGFR），採用免疫酶聯吸附法（ELISA）測定Fetuin-A值，頸動脈綵色超聲檢測頸動脈鈣化。結果隨著eGFR的下降，Fetuin-A水平在CKD4期患者明顯低于CKD3期（P<0.05），CKD5期明顯低于CKD4期（P<0.05），Fetuin-A與eGFR呈線性正相關；頸動脈鈣化的髮生率隨eGFR下降逐漸增加，CKD5期頸動脈鈣化髮生率最高，等級相關分析顯示Fetuin-A與頸動脈鈣化的髮生呈負相關，Logistic迴歸分析顯示血漿Fetuin-A水平降低是ESRD患者頸動脈鈣化的危險因素。結論Fetuin-A血漿濃度隨腎功能下降逐漸下降，是CKD患者頸動脈鈣化髮生的危險因素之一。
목적：연구혈청태구단백A（fetuin-A）여만성신장병환자（CKD）잔존신공능적관계급기대경동맥개화적영향。방법채집CKD3기、4기、5기각20례환자적혈액양본，검측혈청기항、개、린、백단백、지단백급담고순수평，응용MDRD공식채용혈청기항계산신소구려과솔（eGFR），채용면역매련흡부법（ELISA）측정Fetuin-A치，경동맥채색초성검측경동맥개화。결과수착eGFR적하강，Fetuin-A수평재CKD4기환자명현저우CKD3기（P<0.05），CKD5기명현저우CKD4기（P<0.05），Fetuin-A여eGFR정선성정상관；경동맥개화적발생솔수eGFR하강축점증가，CKD5기경동맥개화발생솔최고，등급상관분석현시Fetuin-A여경동맥개화적발생정부상관，Logistic회귀분석현시혈장Fetuin-A수평강저시ESRD환자경동맥개화적위험인소。결론Fetuin-A혈장농도수신공능하강축점하강，시CKD환자경동맥개화발생적위험인소지일。
Objective To investigate the association of fetuin-A with residual renal function and carotid artery calcification in patients with chronic kidney disease (CKD). Methods Blood examples were collected form 60 CKD patients in stages CKD3 to CKD5 (20 patients per stage) for measurement of serum fetuin-A, albumin, calcium, phosphorus and parathyroid hormone, cholesterol, triglycercide, low-density lipoprotein, and high-density lipoprotein. MDRD equation was used to calculate the estimated glomerular filtration rate (eGFR), and ELISA was used to detect serum fetuin-A. Color Doppler ultrasound was performed to measure carotid intima-media thickness (CIMT). Results As the eGFR decreased, serum fetuin-A significantly decreased in CKD5 stage compared with that in CKD4 stage (P<0.05);compared with that in CKD3 stage, serum fetuin-A level was significantly lowered in CKD4 stage (P<0.05). Linear regression analysis suggested a significant positive correlation between fetuin-A and eGFR. The rate of carotid artery calcification was the highest in CKD5 stage. Rank correlation analysis showed a negative correlation between fetuin-A and cIMT, and logistic regression analysis identified decreased serum Fetuin-A as a risk factor of carotid artery calcification. Conclusion Serum fetuin-A decreases following the decrease in eGFR, and decreased serum Fetuin-A level is a risk factor of carotid artery calcification in CKD patients.
