温州医科大学学报
溫州醫科大學學報
온주의과대학학보
Journal of Wenzhou Medical University
2015年
4期
281-285
,共5页
分泌型Klotho蛋白%血液透析%冠状动脉%动脉粥样硬化
分泌型Klotho蛋白%血液透析%冠狀動脈%動脈粥樣硬化
분비형Klotho단백%혈액투석%관상동맥%동맥죽양경화
secretory Klotho%hemodialysis%coronary artery%atherosclerosis
目的：探讨维持性血液透析（MHD）患者血清分泌型Klotho蛋白与冠状动脉粥样硬化的关系。方法：收集152例MHD患者临床资料，ELISA法检测血清分泌型Klotho蛋白浓度。根据冠脉造影检查结果了解患者冠状动脉粥样硬化情况，分别记录冠状动脉病变累及支数及计算冠状动脉病变Syntax积分。logistic回归分析法分析MHD患者发生冠状动脉粥样硬化的危险因素，受试者工作特征曲线（ROC）评价血清分泌型Klotho蛋白诊断冠状动脉粥样硬化的准确性与特异性。结果：152例MHD患者中81例存在冠状动脉粥样硬化。血清分泌型Klotho蛋白浓度四分位数小于P25的I组患者冠状动脉粥样硬化比率最高，Klotho蛋白水平与冠状动脉粥样硬化呈负相关（r=-0.260，P=0.001）。血清分泌型Klotho蛋白浓度与冠状动脉病变支数呈负相关（r=-0.268，P=0.001）；与冠状动脉病变Syntax积分呈负相关（r=-0.223，P=0.046）。logistic回归分析显示，血清分泌型Klotho浓度降低（OR=3.125，95%CI 1.298～7.522）是冠状动脉粥样硬化的独立危险因素（P=0.011）；ROC分析显示Klotho蛋白诊断冠状动脉粥样硬化的曲线下面积（AUC）为0.650（截点为373.825 pg/mL，其敏感性为81.7%，特异性为44.4%）。结论：MHD患者血清分泌型Klotho蛋白水平与冠状动脉粥样硬化相关，与冠状动脉粥样硬化严重程度负相关；Klotho蛋白浓度降低是患者发生冠状动脉粥样硬化的独立危险因素。血清分泌型Klotho蛋白浓度检测有助于诊断MHD患者冠状动脉粥样硬化，并可判断冠状动脉病变的严重程度。
目的：探討維持性血液透析（MHD）患者血清分泌型Klotho蛋白與冠狀動脈粥樣硬化的關繫。方法：收集152例MHD患者臨床資料，ELISA法檢測血清分泌型Klotho蛋白濃度。根據冠脈造影檢查結果瞭解患者冠狀動脈粥樣硬化情況，分彆記錄冠狀動脈病變纍及支數及計算冠狀動脈病變Syntax積分。logistic迴歸分析法分析MHD患者髮生冠狀動脈粥樣硬化的危險因素，受試者工作特徵麯線（ROC）評價血清分泌型Klotho蛋白診斷冠狀動脈粥樣硬化的準確性與特異性。結果：152例MHD患者中81例存在冠狀動脈粥樣硬化。血清分泌型Klotho蛋白濃度四分位數小于P25的I組患者冠狀動脈粥樣硬化比率最高，Klotho蛋白水平與冠狀動脈粥樣硬化呈負相關（r=-0.260，P=0.001）。血清分泌型Klotho蛋白濃度與冠狀動脈病變支數呈負相關（r=-0.268，P=0.001）；與冠狀動脈病變Syntax積分呈負相關（r=-0.223，P=0.046）。logistic迴歸分析顯示，血清分泌型Klotho濃度降低（OR=3.125，95%CI 1.298～7.522）是冠狀動脈粥樣硬化的獨立危險因素（P=0.011）；ROC分析顯示Klotho蛋白診斷冠狀動脈粥樣硬化的麯線下麵積（AUC）為0.650（截點為373.825 pg/mL，其敏感性為81.7%，特異性為44.4%）。結論：MHD患者血清分泌型Klotho蛋白水平與冠狀動脈粥樣硬化相關，與冠狀動脈粥樣硬化嚴重程度負相關；Klotho蛋白濃度降低是患者髮生冠狀動脈粥樣硬化的獨立危險因素。血清分泌型Klotho蛋白濃度檢測有助于診斷MHD患者冠狀動脈粥樣硬化，併可判斷冠狀動脈病變的嚴重程度。
목적：탐토유지성혈액투석（MHD）환자혈청분비형Klotho단백여관상동맥죽양경화적관계。방법：수집152례MHD환자림상자료，ELISA법검측혈청분비형Klotho단백농도。근거관맥조영검사결과료해환자관상동맥죽양경화정황，분별기록관상동맥병변루급지수급계산관상동맥병변Syntax적분。logistic회귀분석법분석MHD환자발생관상동맥죽양경화적위험인소，수시자공작특정곡선（ROC）평개혈청분비형Klotho단백진단관상동맥죽양경화적준학성여특이성。결과：152례MHD환자중81례존재관상동맥죽양경화。혈청분비형Klotho단백농도사분위수소우P25적I조환자관상동맥죽양경화비솔최고，Klotho단백수평여관상동맥죽양경화정부상관（r=-0.260，P=0.001）。혈청분비형Klotho단백농도여관상동맥병변지수정부상관（r=-0.268，P=0.001）；여관상동맥병변Syntax적분정부상관（r=-0.223，P=0.046）。logistic회귀분석현시，혈청분비형Klotho농도강저（OR=3.125，95%CI 1.298～7.522）시관상동맥죽양경화적독립위험인소（P=0.011）；ROC분석현시Klotho단백진단관상동맥죽양경화적곡선하면적（AUC）위0.650（절점위373.825 pg/mL，기민감성위81.7%，특이성위44.4%）。결론：MHD환자혈청분비형Klotho단백수평여관상동맥죽양경화상관，여관상동맥죽양경화엄중정도부상관；Klotho단백농도강저시환자발생관상동맥죽양경화적독립위험인소。혈청분비형Klotho단백농도검측유조우진단MHD환자관상동맥죽양경화，병가판단관상동맥병변적엄중정도。
Objective:To determine the relationship between serum secretory Klotho and coronary ath-erosclerosis in maintenance hemodialysis (MHD) patients. Methods:One hundred and iffty-two cases of MHD patients, who were underwent coronary artery angiography, were collected prospectively. Serum secretory Klotho was detected by ELISA. Coronary artery lesions involving the count and Syntax score were recorded by the result of coronary angiography examination. Logistic regression analysis was used to determine the risk factor of coronary atherosclerosis in MHD patients. The ROC analysis was applied to evaluate the diagnostic value of secretory Klotho in coronary atherosclerosis. Results:Eigty-one patients had coronary atherosclerosis. Serum secretory Klotho concentration was negatively correlated with coronary atherosclerosis (r=-0.260, P=0.001). Secretory Klotho and counts of coronary artery lesion showed a negative correlation (r=-0.268, P=0.001). Secre-tory Klotho was also negatively correlated with Syntax score (r=-0.223, P=0.046). Logistic regression analysis showed that lower secretory Klotho level was an independent risk factor for coronary atherosclerosis (OR=3.125, 95%CI 1.298~7.522). ROC-AUC of serum secretory Klotho for coronary atherosclerosis was 0.650 (cut off 373.825 pg/mL, accuracy 81.7%, speciifcity 44.4%). Conclusion:Serum secretory Klotho of MHD patients is associated with coronary atherosclerosis, and is negatively related to the severity of coronary atherosclerosis, also is an independent risk factor in MHD patients with coronary atherosclerosis. Serum secretory Klotho may have diagnostic value for coronary atherosclerosis in MHD patients, and can judge the severity of coronary artery lesions.
