中国血液净化

中国血液净化 ›› 2022, Vol. 21 ›› Issue (07): 502-506.doi: 10.3969/j.issn.1671-4091.2022.07.009

• 临床研究 • 上一篇    下一篇

维持性血液透析患者血清骨硬化蛋白、骨桥蛋白的表达及其与血管钙化的相关性

钟 杰    安春兰    张家丽   

  1. 617000 攀枝花，1攀枝花学院附属医院肾内科
    621004 绵阳，    2四川省绵阳市游仙区人民医院肾内科
    643000 自贡，    3四川省自贡市第三人民医院肾内科

  • 收稿日期:2021-12-02 修回日期:2022-04-15 出版日期:2022-07-12 发布日期:2022-07-12
  • 通讯作者: 钟杰 E-mail:zhongyiyuanhe@163.com

The correlation between serum osteosclerosis protein and osteopontin levels and vascular calcification in maintenance hemodialysis patients 

  1. Department of Nephrology, The Affiliated Hospital of Panzhihua University, Panzhihua 617000, China;  Department of Nephrology,
    Youxian District People's Hospital of Mianyang City, Mianyang 621004, China;      Department of Nephrology,
    Zigong Third People's Hospital of Sichuan Province, Zigong 643000, China
  • Received:2021-12-02 Revised:2022-04-15 Online:2022-07-12 Published:2022-07-12

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摘要： 目的 分析维持性血液透析(maintenance hemodialysis，MHD)患者血清骨硬化蛋白(serum
osteosclerosis protein,SOST)、骨桥蛋白(osteopontin,OPN)的表达及其与血管钙化的相关性。 方
法 选取2017年6月～2020年9月期间于攀枝花学院附属医院等3家医院肾内科接受MHD治疗并随诊的
200例患者为研究对象，所有患者均于入院首次进行血液透析治疗时检测血清SOST、OPN水平，记录随访
期间血管钙化发生情况并分组，比较基线资料及血清SOST、OPN水平。分析MHD患者血清SOST、OPN的表
达与血管钙化的相关性。 结果 200例MHD患者中发生血管钙化64例，发生率为32%；钙化组血磷、血
钙、OPN水平均高于非钙化组，SOST低于非钙化组，差异有统计学意义(t=4.315、5.556、8.611、6.208，均
P＜0.001
)；经多因素Logistics回归分析结果显示，血磷、血钙、SOST、OPN表达与维持性血液透析患者血
管 钙 化 发 生 相 关 (OR=8.590、5.078、0.489、1.062，95% CI：2.752～26.815、2.086～12.362、0.352～
0.680、1.039～1.085，均P＜0.001)；ROC曲线显示，血清SOST、OPN及两者联合预测均患者血管钙化发生
的AUC均＞0.70；决策曲线显示，在高风险阈值0.16～0.84内，血清SOST、OPN联合的预测模型评估维持
性血液透析患者血管钙化发生的净收益率优于单独检测。 结论 血清SOST、OPN在MHD发生血管钙化患
者中异常表达，与血管钙化发生密切相关。

关键词: 慢性肾衰竭, 维持性血液透析, 骨硬化蛋白, 骨桥蛋白, 血管钙化

Abstract: Objective To analyze the serum osteosclerosis protein (SOST) and osteopontin (OPN) levels and their correlation with vascular calcification in maintenance hemodialysis (MHD) patients. Methods
A total of 200 patients who received MHD and follow-up study in the Nephrology Departments of the three
hospitals during June 2017 to September 2020 were recruited as the research subjects. Serum SOST and OPN
were assayed before the first hemodialysis. The presence of vascular calcification during follow-up period was
recorded. Their baseline data and serum SOST and OPN levels were compared, and the correlation between
serum SOST and OPN levels and vascular calcification was evaluated. Results Among the 200 MHD patients, 64 cases had vascular calcification with the incidence of 32% (64/200). Serum phosphorus, calcium and
OPN were higher while serum SOST was lower in the calcification group as compared with those in the noncalcification group (t=4.315, 5.556, 8.611 and 6.208 respectively, P<0.001). Multivariate logistic regression
showed that serum phosphorus, calcium, SOST and OPN levels correlated with vascular calcification in the
MHD patients (OR=8.590, 5.078, 0.489 and 1.062 respectively; 95% CI 2.752～26.815, 2.086～12.362,
0.352～0.680 and 1.039～1.085 respectively; P<0.001). ROC curve showed that the AUC values of serum
SOST, OPN, and their combination in predicting vascular calcification were all >0.70; the decision curve
showed that in the range of high- risk threshold of 0.16- 0.84, the prediction model using combined serum
SOST and OPN levels was better than that using one of the serum levels in assessing the net benefit rate of
vascular calcification in MHD patients. Conclusion Serum SOST and OPN levels were abnormal in MHD patients with vascular calcification. They were closely related to vascular calcification.

Key words: Chronic renal failure, Maintenance hemodialysis, Osteosclerosis protein, Osteopontin, Vascular calcification

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