维持性血液透析患者动脉钙化与维生素K 关系的研究进展

doi:10.3969/j.issn.1671-4091.2021.10.003

摘要/Abstract

摘要：

【摘要】维持性血液透析患者中普遍存在动脉钙化现象，动脉钙化的发生与心血管事件的发生密切相关。基质γ-羧基谷氨酸蛋白(matrix γ-carboxyglutamate protein，MGP)作为一种维生素K 依赖蛋白，可以通过多途径抑制动脉钙化的进展。研究证实，去磷酸化、未羧化基质γ-羧基谷氨酸蛋白(dephosphorylated-uncarboxylated matrix γ-carboxyglutamate protein，dp-ucMGP)作为一类无活性MGP，与维持性血液透析患者死亡风险相关。维生素K 作为维生素K 依赖蛋白(vitamin K-dependent proteins，VKDPs)活化的重要底物，决定了循环VKDP 水平。在维持性血液透析患者中，补充维生素K 可以显著降低去磷酸化、未羧化基质γ-羧基谷氨酸蛋白水平，但尚缺乏相关前瞻性研究明确存在动脉钙化的维持性血液透析患者是否可以从补充维生素K中获益。

关键词: 动脉钙化, 维生素K依赖蛋白, 去磷酸化、未羧化基质γ-羧基谷氨酸蛋白, 颈-股动脉脉搏波传导速度, 钙化防御

Abstract: 【Abstract】The incidence of arterial calcification is higher in maintenance hemodialysis (MHD) patients with chronic kidney disease. Arterial calcification is closely related to the cardiovascular events in these patients. Matrix γ-carboxyglutamate protein (MGP) is a vitamin K dependent protein, which inhibits the progression of arterial calcification through multiple pathways. Studies have confirmed that dephosphorylated and uncarboxylated MGP (dp-ucMGP) is a type of inactive MGP, which is related to the risk of death in MHD patients. Vitamin K is an important substrate for the activation of vitamin K dependent proteins (VKDPs), and
determines the level of circulating VKDPs. Vitamin K supplementation for MHD patients can significantly reduce the level of dp-ucMGP. However, prospective studies providing confirmed data that MHD patients with arterial calcification benefited from vitamin K supplementation are yet insufficient.

Key words: Arterial calcification, Vitamin K- dependent proteins, Dephosphorylated- uncarboxylated matrix γ-carboxyglutamate protein (dp-ucMGP), Carotid-femoral pulse wave velocity, Calcification defense

中图分类号:

R459.5

黎杨梦琦, 李英. 维持性血液透析患者动脉钙化与维生素K 关系的研究进展[J]. 中国血液净化, 2021, 20(10): 657-660.

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