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- 2018
血清sclerostin水平与维持性血液透析患者血管钙化的关系
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Abstract:
摘要：目的 探讨血清sclerostin水平与慢性肾衰竭(chronic renal failure, CRF)血液透析患者血管钙化(vascular calcification, VC)的关系。方法 选取2017年3月至5月于我院行维持性血液透析的94例CRF患者,收集相关临床资料，采用酶联免疫吸附法测定血清sclerostin水平，采用胸部计算机断层扫描(computed tomography, CT)明确血管钙化(包括主动脉钙化和冠状动脉钙化)情况，分析血清sclerostin水平与血管钙化的关系。结果 钙化组患者与非钙化组患者相比，血清sclerostin水平显著升高[(121.23±53.13) vs. (81.84±30.20)pmol/L，P<0.05]。多因素Logistic回归分析显示血清sclerostin(OR=1.038，P<0.01)与透析患者VC发生相关。当sclerostin水平为91.27pmol/L时，灵敏度和特异度均为0.71，此时灵敏度和特异度之和最大，因此，预测VC的最佳截断值为91.27pmol/L；联合年龄、糖尿病、钙和全段甲状旁腺激素时预测VC的灵敏度为0.91，特异度为0.74。结论 血清sclerostin水平在透析患者中显著升高,并与透析患者VC发生相关，对VC有一定的预测价值。
ABSTRACT: Objective?? To elucidate the association between serum sclerostin and vascular calcification (VC) in maintenance dialysis patients with chronic renal failure (CRF). Methods?? Blood samples were collected from 94 maintenance dialysis patients at our hospital between March and May 2017 and the related clinical biochemical data were measured using standard auto-analyzer techniques. Serum sclerostin level was measured using a quantitative sandwich enzyme-linked immunosorbent assay (ELISA) method. Chest computed tomography (CT) was performed to measure VC. The association between sclerostin level and VC was analyzed. Results?? Serum sclerostin level was significantly higher in dialysis patients with VC than in those patients without VC [(121.23±53.13) vs. (81.84±30.20)pmol/L, P<0.01]. The serum sclerostin level (OR=1.038, P<0.01) was associated with VC determined by multivariate logistic regression. Receiver operating characteristic curve suggested that the cut-off number of sclerostin level predicting VC was 91.27pmol/L, and the sensitivity and specificity were both 0.71. The sensitivity was 0.91 and the specificity was 0.74 when sclerostin level was combined with age, diabetes, calcium and iPTH to predict VC. Conclusion? ?Serum sclerostin level is higher in dialysis patients with VC compared with those without VC, and it is associated with VC in dialysis patients, suggesting that it has some value in predicting VC
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